Coronary artery vasospasm and emotional stress: a hypothetical link to atherosclerosis

A large body of evidence suggests that psychosocial behavior may contribute to the formation of coronary heart disease. It is proposed that emotionally-induced coronary vasospasm leads to the development of coronary atherosclerosis. This hypothesis is based on two observations: a) coronary vasospasm is present at the site of organic lesions and may be antecedent to the development of the atherosclerotic plaque, and b) emotional stress results in an alpha adrenergically mediated increase in coronary vascular resistance.