Mental Stress and Myocardial Ischemia [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 1995; 23(2): 95-99

Mental Stress and Myocardial Ischemia

Seyfi USLUBAŞ1, Kemal YEŞİLÇİMEN1, Metin GÜRSÜRER1, İzzet ERDİNLER1, Recep ÖZTÜRK1, Ayşe EMRE1, Birsen ERSEK1, Tezer ULUSOY1

The purpose of this study was to determine whether mental stress played a significant role in myocardial ischemia. 45 patients were taken for mathematical mental stress testing (MST), exercise treadmill testing (ET) and coronary angiography. Subsequently, we identifed 34 patients with a critical coronary lesion angiography (group I) and compared them with 11 patients with normal coronary angiograms (group II). Six patients in group I had transient ischemic changes on ECG on MST. In contrast, no ECG changes were observed in group II. While the sensitivity and specificity of MST were 17.6 % and 100%, respectively, the sensitivity and specificity of ET were 73.5 % and 90.9, respectively. It was observed that MST increased the heart rate (HR), systolic blood pressure (SBP) and the rate-pressure product (DP) in a significant manner. With MST, the HR increased from 81.3±13.7 beats per minute (bpm) to 99.6±15.8 in group 1 (p<0.01) and from 84±14.1 to 101.1±20.2 (p<0.01) in group II, while SBP increased from 137.5±20.4 mmHg to 161.8±24.9 in group I 5p<0.01) and from 140.1±14.6 to 168.7±22.6 in group II (p<0.01). Furthermore, the DP increased from 11.063±4.921 mmHgxbpm to 15.563±4.184 in group I (p<0.01) and from 10.954±4.872 to 16.09±4.685 in group II (p<0.01). The increases in HR, SBP, and DP were more marked with ET in both groups. Finally, the value for the DP obtained from ET (28.244±5.583 mmHgxbpm) was found to be higher than that of MST (15.692±5.341) (p<0.005). Our data confirmed that mental stress causes myocardial ischemia by increasing the HR and SBP. However, unlike ET, MST has not been recommended as a screening test in establishing the diagnosis of myocardial ischemia.

Keywords: Mental stress, myocardial ischemia

How to cite this article
Seyfi USLUBAŞ, Kemal YEŞİLÇİMEN, Metin GÜRSÜRER, İzzet ERDİNLER, Recep ÖZTÜRK, Ayşe EMRE, Birsen ERSEK, Tezer ULUSOY. Mental Stress and Myocardial Ischemia. Turk Kardiyol Dern Ars. 1995; 23(2): 95-99
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