Why the study?
Diagnostic criteria, pathogenesis, and treatment of mental stress-induced myocardial ischemia remain in the clinical exploration stage despite its association with poor cardiovascular prognosis.
This review highlights that mental stress-induced myocardial ischemia is a distinct clinical entity associated with adverse cardiovascular outcomes, particularly in women, driven by microvascular and endothelial dysfunction.
MSIMI often escapes diagnosis despite portending poor prognosis; leaves open need for validated screening and targeted trials in CAD.
Myocardial ischemia resulting from psychological stress [mental stress-induced myocardial ischemia (MSIMI)] refers to the condition wherein psychosocial and psychological stimulations cause myocardial ischemia in patients with coronary heart disease, which is different from drug-induced myocardial ischemia. Therefore, this condition often escapes diagnosis, portends clinical risk, and affects the quality of life of MSIMI survivors. MSIMI is closely related to the poor prognosis of cardiovascular diseases, especially in young women, according to recent randomized, controlled trials (RCTs) on MSIMI. These RCTs involved different sample sizes, interventional measures, and detection techniques. Moreover, differences exist regarding the prevalence rate, distribution characteristics, possible pathogenesis, and clinical significance. Nevertheless, currently, the diagnostic criteria, pathogenesis, and treatment of MSIMI are still in the clinical exploration stage. Hence, considering recent RCTs, this paper summarizes the research status of MSIMI from the aspects of pathogenesis, diagnosis, and treatment strategies to provide a theoretical basis for the follow-up diagnostic methods and treatment guidelines for MSIMI.
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Na Huan (2020) studied this question.
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