[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-416666-105":59,"doc-detail-416666-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","stress-and-acute-coronary-syndrome","Stress and Acute Coronary Syndrome","","Atherosclerosis progresses under multiple risk factors, including hypercholesterolemia, smoking, and hypertension, and vulnerable plaque rupture can precipitate myocardial infarction. Advances in risk-factor management have improved incidence and outcomes, yet triggers of plaque rupture—especially significant physical and mental stress—require further attention. The review emphasizes emotional stress as an initiator of acute cardiac events, highlighting associations with natural disasters and anger-related stress, particularly in patients with coronary disease or major risk factors, and notes clinical focus during hospitalization and rehabilitation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/stress-and-acute-coronary-syndrome/416666/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/stress-and-acute-coronary-syndrome/416666.png","ImageObject",300,407,{"name":92,"@type":93},"Fans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What role does plaque rupture play in acute myocardial infarction?","Question",{"text":113,"@type":114},"Plaque rupture is described as the major cause of acute myocardial infarction, and vulnerable plaque features such as a thin fibrous cap and necrotic core support this mechanism.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How can acute stress trigger acute coronary events?",{"text":118,"@type":114},"The review explains that stress activates sympathomimetic pathways, increasing adrenaline release and oxygen demand while reduced supply from narrowed vessels can lead to ischemia, infarction, and arrhythmias.",{"name":120,"@type":111,"acceptedAnswer":121},"Which stress-related situations are linked to higher cardiac risk in the review?",{"text":122,"@type":114},"Emotional stressors such as severe life events, anger, stressed marital relations, stressful working conditions, and even events like earthquakes are associated with increased cardiac death and acute myocardial infarction, especially during early morning hours.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},416666,1790864923,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46,"preview_page_count":4},5909892330395,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review Cardiol Res. 2025;16(6):467-474  \nStress and Acute Coronary Syndrome  \nShereifH. Rezkallaa, d, Robert A. Klonerb, c  \nAbstract  \nA plethora of risk factors, such as hypercholesterolemia, smoking, hypertension, and others lead to the progression of coronary atherosclerosis. Vulnerable plaques are formed, and rupture of such plaques results in the development of myocardial infarction. Great progress has been made in the medical community’s focus on management of risk factors, with clear improvement in the incidence and outcome of myocardial infarction. However, triggers of plaque rupture, which include significant physical and mental stress, need more attention. In this report, we focused on the effect of emotional stress in triggering various acute cardiac events. Natural disasters such as earthquakes result insignificant emotional stress, and have been associated with substantial increases in cardiac death and acute myocardial infarction. This is more pronounced with severe events, particularly if they occur in the early morning hours. Anger and severe emotional stress from various life events, particularly from stressed marital relations or stressful working conditions, will result in markedly increased occurrence of myocardial infarction. This is more pronounced in patients with known coronary artery disease or significant risk factors. Providers need to focus on management of stress during hospitalization for myocardial infarction, as well as in the rehabilitation phase of such events.  \nKeywords: Acute coronary syndrome; Coronary atherosclerosis; Myocardial infarction; Risk factors; Stress  \nIntroduction  \nPlaque rupture is the major cause of acute myocardial infarction and appears to be the dominant mechanism in at least threequarters of acute events [1] . A vulnerable plaque is characterized by a large necrotic core, a thin fibrous cap, intra-plaque hemorrhage, and an infiltration of inflammatory cells [2] . A  \nManuscript submitted July 24, 2025, accepted September 5, 2025  \nPublished online December 20, 2025  \naMarshfield Clinic Research Institute, Marshfield, WI, USA bCardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, CA, USA  \ncCardiovascular Division, Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA dCorresponding Author: Shereif H. Rezkalla, Marshfield Clinic Research In  \nstitute, Marshfield, WI, USA. Email: [rezkalla.shereif@marshfieldresearch.org](rezkalla.shereif@marshfieldresearch.org)  \ndoi: [https://doi.org/10.14740/cr2123](https://doi.org/10.14740/cr2123)  \nplethora of risk factors, such as dyslipidemia, hypertension, smoking, diabetes, and a variety of genetic predispositions, lead to the development of vascular plaques. Stress, either physical or emotional, is a trigger for acute coronary events, including plaque rupture, with the final development of myocardial infarction and acute coronary syndromes [3] . The purpose of this paper is to describe the types of triggers that have been associated with acute coronary events, with emphasis on triggers that cause acute episodes of psychological and/or physical stress. The papers reviewed were chosen from a literature search performed on PubMed using key terms including “acute cardiac event,”“emotional stress,” “physical stress,” “natural disasters,” and“Takotsubo cardiomyopathy,” and included studies published in peer-reviewed journals. Because of the nature of the events reported, most of these studies do not have a typical control group and are descriptive in nature, and the authors recognize this asa potential limitation. This report will focus on various types of stress and awareness of these triggers, which may help avoid the development of these events, particularly in people who have known coronary artery disease or are vulnerable to the development of coronary atherosclerosis.  \nMechanisms  \nHow does acute psychologic or physical stress trigger an acute c","cbCaigUAVJUy3CWI","https://ap.wps.com/l/cbCaigUAVJUy3CWI","pdf",951649,"English","# Abstract\n# Introduction\n# Mechanisms","[{\"question\":\"What role does plaque rupture play in acute myocardial infarction?\",\"answer\":\"Plaque rupture is described as the major cause of acute myocardial infarction, and vulnerable plaque features such as a thin fibrous cap and necrotic core support this mechanism.\"},{\"question\":\"How can acute stress trigger acute coronary events?\",\"answer\":\"The review explains that stress activates sympathomimetic pathways, increasing adrenaline release and oxygen demand while reduced supply from narrowed vessels can lead to ischemia, infarction, and arrhythmias.\"},{\"question\":\"Which stress-related situations are linked to higher cardiac risk in the review?\",\"answer\":\"Emotional stressors such as severe life events, anger, stressed marital relations, stressful working conditions, and even events like earthquakes are associated with increased cardiac death and acute myocardial infarction, especially during early morning hours.\"}]","Stress and Acute Coronary Syndrome | PDF",1790606248]