Hi,

Thanks for the query.

Yes, both mental and physical stresses can precipitate a myocardial infarct by being a contributory factor rather than causative.

Multiple explanations’ are sited in literature; most common being increase in adrenaline level which in turn increase blood pressure, heart rate and plaque instability and erosion. But it would be near to impossible to prove or say that it is primarily stress that caused anteroseptal infarct (Myocardial Infarct) or other coronary vessel disease.

"Stress is characterized by an increase in plasma catecholamines and cortisol associated with a rise in heart rate and blood pressure. Plasma epinephrine can increase by a factor of 8 through emotional or physical stress. In contrast, the rise in plasma norepinephrine following physical stress is much higher than that following emotional stress. "
CONCLUSION: A causal relationship between stress and atherosclerosis has not yet been demonstrated in clinical studies. However, there is convincing evidence to accept emotional stress as a potential trigger for the onset of acute myocardial infarction. High physical stress of untrained persons carries an even greater risk for the development of acute myocardial infarction.



Few important references are
1. Gabbay FH, Krantz DS, Kop WJ, et al. Triggers of myocardial ischemia during daily life in patients with coronary artery disease: physical and mental activities, anger and smoking. J Am Coll Cardiol1996;27:585–92.
2. Gullette ECD, Blumenthal JA, Babyak M, et al. Effects of mental stress on myocardial ischemia during daily life. JAMA1997;277:1521–6.
3. Heart 2003;89:475-476 doi:10.1136/heart.89.5.475
Editorial Stress and myocardial infarction

Hope I have given you the information that you were looking for. Do accept the answer if you do not have any further queries. Yet, let me know if I have missed out on any other concerns.

Best wishes

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