1. Figure 3 Effects of stress
Figure 3 | Effects of stress. Schematic model of the physiological responses and pathophysiological effects of stress that contribute to the triggering of cardiovascular events. The response to emotional stress involves changes in the function of the hypothalamus–pituitary–adrenal cortex axis and the autonomic nervous system. Among individuals who already have a high atherosclerotic plaque burden, stress might be the trigger that precipitates the occurrence of a cardiac or cerebrovascular event. The common pathology in acute cardiac events is rupture or disruption of the fibrous cap of the atherosclerotic plaque, coupled with active inflammation and hypercoagulability. Cardiac electrical instability, myocardial ischaemia, and possibly excessive levels of circulating catecholamines are also contributing factors. Stress-related clinical events include ventricular tachycardia and ventricular fibrillation, atrial fibrillation, myocardial infarction and other forms of acute coronary syndromes (for example, unstable angina and stress cardiomyopathy), and stroke.
Kivimäki, M. & Steptoe, A. (2017) Effects of stress on the development and progression of cardiovascular disease
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