Mental stress-induced myocardial ischaemia
Mental stress-induced myocardial ischaemia
复制标题
DOI：
10.1136/heartjnl-2014-307306
复制
发表时间：
2016-03-01
期刊：
影响因子：
5.7
通讯作者：
Marber, M. S.
中科院分区：
文献类型：
--
作者：
Arri, S. S.;Ryan, M.;Marber, M. S.
心绞痛的管理取决于症状和心血管风险，共同指导进一步评估，以检测显著的潜在冠状动脉疾病（CAD）。目前的国家健康和护理卓越研究所指南要求，症状是由体力劳动沉淀被定义为典型的心绞痛。[1]然而，还有许多其他应激源可能诱发心肌缺血，包括冷暴露[2]和精神应激。在1772年医学文献中第一次详细描述心绞痛时，William Heberden注意到“它因精神障碍而增加”。3精神应激诱发的心肌缺血（MSIMI）是一种公认的现象，但在缺乏证据基础的情况下，无论是在临床咨询还是随后的调查中，都没有对其进行常规探讨。重大不确定性依然存在;特别是，MSIMI与运动诱发的心肌缺血有何不同，它对缺血性心脏病患者有何特殊意义？
The management of angina is determined by symptoms and cardiovascular risk, together guiding further assessment in order to detect significant underlying coronary artery disease (CAD). The current National Institute for Health and Care Excellence guidelines require that symptoms are precipitated by physical exertion to be defined as typical angina. 1 There are, however, a number of other stressors that may induce myocardial ischaemia, including cold exposure 2 and mental stress. In the first detailed description of angina pectoris in the medical literature in 1772, William Heberden noted “it is increased by disturbance of the mind”. 3 Mental stress-induced myocardial ischaemia (MSIMI) is a recognised phenomenon, but in the absence of an evidence base it is not routinely explored during either the clinical consultation or subsequent investigations. Significant uncertainties remain; in particular, how does MSIMI differ from exercise-induced myocardial ischaemia, and does it hold any particular significance for patients with ischaemic heart disease?