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      Acute Pulmonary Edema Provoked by Psychologic Stress

      a , b , a

      Cardiology

      S. Karger AG

      Stress, Acute pulmonary edema, Myocardial infarction

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          Abstract

          Emotional stress has been considered responsible for life-threatening ventricular arrhythmias but acute stress-induced heart failure has not been reported in man. Two patients with recent uncomplicated myocardial infarction presenting acute pulmonary edema immediately after psychologic stress testing are the object of this report. Four stressors, mental arithmetic, 30 emotionally involving questions (Sacks’ test modified), an image quiz (Raven’s matrices) and white noise were administered during hemodynamic monitoring (Swan-Ganz catheter) in a 3-min stress-5-min recovery sequence. Response to the stressors was not unusual; greatest cardiovascular response occurred during mental arithmetic, least during noise and intermediate patterns were induced by the other stressors. Heart rate and systemic blood pressure, markers of autonomic activation, increased moderately. Neither ventricular arrhythmias nor ischemic electrocardiographic changes were observed during or after stress testing. Complete recovery followed each stress-induced cardiovascular response. About 10 min after completing stress testing, acute pulmonary edema occurred in both patients neither of whom had presented other episodes of acute pulmonary edema, suggesting that psychologic stress may induce pump dysfunction in patients with latent heart failure.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1987
          1987
          11 November 2008
          : 74
          : 3
          : 229-235
          Affiliations
          aDivision of Cardiology and bPsychology Unit, ‘Clinica del Lavoro’ Foundation, Medical Center of Rehabilitation, Veruno, Novara, Italy
          Article
          174202 Cardiology 1987;74:229–235
          10.1159/000174202
          3594512
          © 1987 S. Karger AG, Basel

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          Page count
          Pages: 7
          Categories
          Case Report

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