ACUTE MYOCARDIAL-INFARCTION TRIGGERED BY EMOTIONAL-STRESS

Myocardial infarction has been shown to have a circadian pattern of occurrence, with a significantly increased incidence in the early morning hours.1 Recognition that onset of acute coronary syndromes may not occur as a random event has led investigators to search for triggers of myocardial infarction.2 Both psychological and physical stresses have been implicated as possible triggers. However, thus far only excessive physical exertion has been temporally linked to onset of pathologically documented acute myocardial infarction.3 We report the first case of an acute myocardial infarction associated with extreme emotional upset, which resulted in cardiogenic shock and was successfully reversed by rapid treatment with thrombolytic therapy. © 1992.