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Discusses the pathophysiological linkage between acute sympathetic nervous activation during severe mental stress and adverse cardiac events.
I nappropriate and excessive activation of the sympathetic nervous system has been invoked as a cause of coronary heart disease. This pathophysiological linkage can take 2 forms. The most direct and explicit is when acute sympathetic nervous activation triggers adverse cardiac events (myocardial infarction, atrial fibrillation, ventricular arrhythmias, and Takotsubo cardiomyopathy have all been documented) during acute severe mental stress. 1 Systematic evidence has been gathered at times of disasters, including war, missile attacks on civilians, and earthquakes, that strongly supports this proposition. The recently published and already celebrated
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Murray Esler (2010) studied this question.
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