Emotional stress can precipitate severe, reversible left ventricular dysfunction

NEJM -- Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress So the title of the paper is a but clumsy - but this is an interesting paper that makes us think twice about "noncardiac" chest pain. The authors studied patients who were quite ill, and subjected them to rather invasive testing (angiography, myocardial biopsy) and determined that there was significant myocardial injury assosicated with increasted catecholamine levels. Of course this is no surprise .. but it is an objective measure that emotional stress (and other stress) can injure the heart. A caveat is that the patients in the study were over 60. So the 25 year old who complains of chest pain when they go to the supermarket is much more likely to be having a panic attack than a heart attack. Hmm .. But maybe they're not "just fine" ... according to this paper in circulation, women who have anxiety disorder are much more likely to die of sudden cardiac events.