[Influence of emotional stress and behavior during acute myocardial infarction on prognosis]

Seventeen cases of acute myocardial infarction (AMI) with emotional stress (group A) and 54 cases with basically stable emotion (group B) were compared with respect to three major complications (arrhythmia, cardiac insufficiency of grade 3 and 4 and cardiogenic shock) and therapeutic effect. The results showed that the incidences of the three complications in group A were significantly higher than those in group B (P less than 0.05), and the clinical condition was more serious in the former group. Response to narcotics showed that number of patients requiring more than 3 injections of either dolantine 50 mg or morphine 5 mg was significantly greater in group A than in group B (P less than 0.001). Sigma ST was not found to be significantly different between the two groups. However, the duration of elevation of ST segment was significantly longer in group A than in group B (P less than 0.01). It is suggested that relief of myocardial ischemia is slow in group A. There were five patients in group A with extended infarct size and died during the acute stage. None in the group B showed extension of infarction. The mortality rate in group A significantly higher than that in group B (53% VS 3.7%, P less than 0.001) and it bears no relation with sex, age and the site of infarction on admission. The greater the emotional upheaval the more unfavorable the prognosis. It is shown that excessive emotional stress is an important risk factor of AMI and aggressive measures are required to prevent worsening of the condition.