Acute emotional stress and cardiac arrhythmias

Research output: Contribution to journalArticle

Abstract

Episodes of acute emotional stress can have significant adverse effects on the heart. Acute emotional stress can produce left ventricular contractile dysfunction, myocardial ischemia, or disturbances of cardiac rhythm. Although these abnormalities are often only transient, their consequences can be gravely damaging and sometimes fatal. Despite the many descriptions of catastrophic cardiovascular events in the setting of acute emotional stress, the anatomical substrate and physiological pathways by which emotional stress triggers cardiovascular events are only now being characterized, aided by the advent of functional neuroimaging. Recent evidence indicates that asymmetric brain activity is particularly important in making the heart more susceptible to ventricular arrhythmias. Lateralization of cerebral activity during emotional stress may stimulate the heart asymmetrically and produce areas of inhomogeneous repolarization that create electrical instability and facilitate the development of cardiac arrhythmias. Patients with ischemic heart disease who survive an episode of sudden cardiac death in the setting of acute emotional stress should receive a β-blocker. Nonpharmacological approaches to manage emotional stress in patients with and without coronary artery disease, including social support, relaxation therapy, yoga, meditation, controlled slow breathing, and biofeedback, are also appropriate to consider and merit additional investigation in randomized trials.

Original languageEnglish (US)
Pages (from-to)324-329
Number of pages6
JournalJournal of the American Medical Association
Volume298
Issue number3
DOIs
StatePublished - Jul 18 2007

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Psychological Stress
Cardiac Arrhythmias
Myocardial Ischemia
Yoga
Relaxation Therapy
Meditation
Functional Neuroimaging
Sudden Cardiac Death
Left Ventricular Dysfunction
Social Support
Coronary Artery Disease
Respiration
Brain

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Acute emotional stress and cardiac arrhythmias. / Ziegelstein, Roy.

In: Journal of the American Medical Association, Vol. 298, No. 3, 18.07.2007, p. 324-329.

Research output: Contribution to journalArticle

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