Andrew J. Foy, A. Bucher, L. V. Van Scoy, Laura D. Scherer
Purpose: The Medical Maximizer-Minimizer Scale (MMS) has been validated to predict preferences for health-care service use on hypothetical vignettes in nonclinical cohorts. Using mixed methods, we sought to determine whether it would predict preferences for cardiac stress testing in a cohort of emergency department (ED) patients with low-risk chest pain within the context of the Health Belief Model (HBM). Design: Patients who met the definition for low-risk chest pain and who were eligible to take a cardiac stress test before being discharged from the hospital were recruited to participate. Each participant provided demographic information and completed the MMS-10 paper-and-pencil scale. They then watched a 7-min informational video on an iPad tablet that provided information about the condition of “low-risk chest pain” and the probabilities of results and outcomes following a cardiac stress test. After the video, participants answered a one-question survey on their intention-to-take (ITT) a cardiac stress test or not and were then interviewed about factors that influenced their decision-making. Interviews were interpreted using a HBM lens. Results: Sixty participants were enrolled in the study who were between the ages of 29 and 80 years with a mean age of 53 (± 10.8); 58% were women and 90% were white. The mean MMS score was 4.6 (± 0.8) and ranged from 2.6 to 6.8. Minimizers accounted for 25% (n = 15) of the cohort while maximizers accounted for 75% (n = 45). MMS scores followed a normal distribution and were found to be mildly correlated with ITT scores (r = 0.25; P = 0.051). The mean ITT scores for individuals with MMS scores in the 1st and 4th quartiles were 3.9 ± 2.2 and 5.9 ± 1.7, respectively. After watching the informational video, individuals' perceptions related to the: (1) low threat posed by the condition, (2) low utility (low benefits + significant barriers) of taking a cardiac stress test, and (3) high benefits of taking a cardiac stress test were all strongly associated with ITT scores in a directional manner. No direct connection was found between minimizer-maximizer preferences and health beliefs after watching the informational video. This may have been due to sample size and underrepresentation of minimizers in the cohort. Conclusions: MMS and health beliefs predicted preferences for cardiac stress testing in ED patients with low-risk chest pain after viewing an informational video on the topic. However, we did not find direct evidence that the relationship between MMS and decision-making is mediated through the formation of perceptions of threat and utility consistent with the HBM. More research is needed to establish this connection and understand how framing of information in the health-care space may interact with stable personality traits to influence decision-making.
{"title":"Medical maximizing-minimizing preferences and health beliefs associated with emergency department patients' intentions to take a cardiac stress test after receiving information about testing","authors":"Andrew J. Foy, A. Bucher, L. V. Van Scoy, Laura D. Scherer","doi":"10.4103/hm.hm_48_21","DOIUrl":"https://doi.org/10.4103/hm.hm_48_21","url":null,"abstract":"Purpose: The Medical Maximizer-Minimizer Scale (MMS) has been validated to predict preferences for health-care service use on hypothetical vignettes in nonclinical cohorts. Using mixed methods, we sought to determine whether it would predict preferences for cardiac stress testing in a cohort of emergency department (ED) patients with low-risk chest pain within the context of the Health Belief Model (HBM). Design: Patients who met the definition for low-risk chest pain and who were eligible to take a cardiac stress test before being discharged from the hospital were recruited to participate. Each participant provided demographic information and completed the MMS-10 paper-and-pencil scale. They then watched a 7-min informational video on an iPad tablet that provided information about the condition of “low-risk chest pain” and the probabilities of results and outcomes following a cardiac stress test. After the video, participants answered a one-question survey on their intention-to-take (ITT) a cardiac stress test or not and were then interviewed about factors that influenced their decision-making. Interviews were interpreted using a HBM lens. Results: Sixty participants were enrolled in the study who were between the ages of 29 and 80 years with a mean age of 53 (± 10.8); 58% were women and 90% were white. The mean MMS score was 4.6 (± 0.8) and ranged from 2.6 to 6.8. Minimizers accounted for 25% (n = 15) of the cohort while maximizers accounted for 75% (n = 45). MMS scores followed a normal distribution and were found to be mildly correlated with ITT scores (r = 0.25; P = 0.051). The mean ITT scores for individuals with MMS scores in the 1st and 4th quartiles were 3.9 ± 2.2 and 5.9 ± 1.7, respectively. After watching the informational video, individuals' perceptions related to the: (1) low threat posed by the condition, (2) low utility (low benefits + significant barriers) of taking a cardiac stress test, and (3) high benefits of taking a cardiac stress test were all strongly associated with ITT scores in a directional manner. No direct connection was found between minimizer-maximizer preferences and health beliefs after watching the informational video. This may have been due to sample size and underrepresentation of minimizers in the cohort. Conclusions: MMS and health beliefs predicted preferences for cardiac stress testing in ED patients with low-risk chest pain after viewing an informational video on the topic. However, we did not find direct evidence that the relationship between MMS and decision-making is mediated through the formation of perceptions of threat and utility consistent with the HBM. More research is needed to establish this connection and understand how framing of information in the health-care space may interact with stable personality traits to influence decision-making.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"267 - 275"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46603796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Loneliness has been associated with different health outcomes in the following domains: general health, well-being, physical health, mental health, sleep, and cognitive function. However, the most significant associations fall into mental health- and well-being-related outcomes. Moreover, loneliness is an identified risk factor for all-cause mortality. This article overviews the systematic and meta-analytic studies, which have investigated epidemiology and etiology, associated medical and neuropsychiatric conditions, and interventions for loneliness. Meta-analyses have associated higher levels/prevalence of loneliness with pathological conditions, including physical (cardiovascular diseases, obesity, and cancer) and mental health conditions (dementia, cognitive impairment, depression, anxiety, suicide, substance abuse, frailty, and addiction). Furthermore, loneliness commonly occurs to people during particular physiological conditions, for example, childhood, adulthood, elderly, pregnancy, and taking care of others. Moreover, young adults commonly experience transient loneliness. For all these pathological/physiological conditions, COVID-19 has been confirmed as a loneliness-worsening condition. Genetic background, in addition to environmental factors, plays a role in the etiology of loneliness. Biomarkers mainly include neural correlates, including aberrations in the structure/function of cognitive or emotional control-related brain regions, inflammatory correlates, and anthropometric measures. The current interventions for loneliness alleviation are mostly focused on older people, for whom the evidence derived from systematic or meta-analytic studies shows none-to-moderate benefits and substantial heterogeneity across studies. The evidence is not adequate to conclude about the effectiveness of interventions in youth. In addition to the need for pathology- and population-specific interventions for loneliness reduction/prevention, there is a need to survey loneliness longitudinally to examine the causality of loneliness-health associations.
{"title":"Loneliness and health: An umbrella review","authors":"N. Rezaei, A. Saghazadeh","doi":"10.4103/hm.hm_51_22","DOIUrl":"https://doi.org/10.4103/hm.hm_51_22","url":null,"abstract":"Loneliness has been associated with different health outcomes in the following domains: general health, well-being, physical health, mental health, sleep, and cognitive function. However, the most significant associations fall into mental health- and well-being-related outcomes. Moreover, loneliness is an identified risk factor for all-cause mortality. This article overviews the systematic and meta-analytic studies, which have investigated epidemiology and etiology, associated medical and neuropsychiatric conditions, and interventions for loneliness. Meta-analyses have associated higher levels/prevalence of loneliness with pathological conditions, including physical (cardiovascular diseases, obesity, and cancer) and mental health conditions (dementia, cognitive impairment, depression, anxiety, suicide, substance abuse, frailty, and addiction). Furthermore, loneliness commonly occurs to people during particular physiological conditions, for example, childhood, adulthood, elderly, pregnancy, and taking care of others. Moreover, young adults commonly experience transient loneliness. For all these pathological/physiological conditions, COVID-19 has been confirmed as a loneliness-worsening condition. Genetic background, in addition to environmental factors, plays a role in the etiology of loneliness. Biomarkers mainly include neural correlates, including aberrations in the structure/function of cognitive or emotional control-related brain regions, inflammatory correlates, and anthropometric measures. The current interventions for loneliness alleviation are mostly focused on older people, for whom the evidence derived from systematic or meta-analytic studies shows none-to-moderate benefits and substantial heterogeneity across studies. The evidence is not adequate to conclude about the effectiveness of interventions in youth. In addition to the need for pathology- and population-specific interventions for loneliness reduction/prevention, there is a need to survey loneliness longitudinally to examine the causality of loneliness-health associations.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"242 - 253"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45388757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Debasish Das, Abhinav Kumar, A. Banerjee, Tutan Das, S. Singh, Manaranjan Dixit
We report an extremely rare case of left ventricular noncompaction (LVNC) cardiomyopathy sparing the anterior ventricular wall in an interesting “necklace” pattern in parasternal short axis view in a 76-year-old female with frequent palpitation and shortness of breath for the last 6 months. Interestingly, the patient had a plethora of basal septal premature ventricular complexes (PVCs) both from the anterior and posterior aspects of the paradoxically thinned-out basal septum and they were not from the segment of noncompacted (NC) myocardium. Our case is unique and the first to describe the LVNC in an interesting shape of “necklace” sparing the left ventricular anterior, anteroseptal, and anterolateral wall and paradoxically arising plethora of septal PVCs from the thinned-out basal septum deteriorating the left ventricular function rapidly in an elderly female in her seventh decade of life. Although commonly in LVNC, the PVCs arise from the NC segment, in this unique case plethora of PVCs paradoxically arising from the basal septum were contributing toward rapid deterioration of left ventricular systolic function in an elderly patient in her seventh decade of life without the presence of conventional risk factors.
{"title":"Necklace pattern left ventricular noncompaction cardiomyopathy with plethora of paradoxic septal premature ventricular complexes: A case report and literature review","authors":"Debasish Das, Abhinav Kumar, A. Banerjee, Tutan Das, S. Singh, Manaranjan Dixit","doi":"10.4103/hm.hm_69_21","DOIUrl":"https://doi.org/10.4103/hm.hm_69_21","url":null,"abstract":"We report an extremely rare case of left ventricular noncompaction (LVNC) cardiomyopathy sparing the anterior ventricular wall in an interesting “necklace” pattern in parasternal short axis view in a 76-year-old female with frequent palpitation and shortness of breath for the last 6 months. Interestingly, the patient had a plethora of basal septal premature ventricular complexes (PVCs) both from the anterior and posterior aspects of the paradoxically thinned-out basal septum and they were not from the segment of noncompacted (NC) myocardium. Our case is unique and the first to describe the LVNC in an interesting shape of “necklace” sparing the left ventricular anterior, anteroseptal, and anterolateral wall and paradoxically arising plethora of septal PVCs from the thinned-out basal septum deteriorating the left ventricular function rapidly in an elderly female in her seventh decade of life. Although commonly in LVNC, the PVCs arise from the NC segment, in this unique case plethora of PVCs paradoxically arising from the basal septum were contributing toward rapid deterioration of left ventricular systolic function in an elderly patient in her seventh decade of life without the presence of conventional risk factors.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"276 - 281"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43360350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We are exposed to noise on a daily basis, and noise pollution is increasingly becoming more intense, especially with more people living in the urban areas. Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide and of global public health concern. Preventing and treating CVDs requires a better understanding of the associated risk factors. There is emerging evidence that noise pollution, especially related to the various forms of transport, is likely a contributor to the pathogenesis and aggravation of CVDs. We review key epidemiological data that address the link between excessive noise exposure and CVDs in humans and present proposed pathophysiological mechanisms underlying this association.
{"title":"Is noise exposure a risk factor for cardiovascular diseases? A literature review","authors":"A. Faria, A. Caldas, I. Laher","doi":"10.4103/hm.hm_48_22","DOIUrl":"https://doi.org/10.4103/hm.hm_48_22","url":null,"abstract":"We are exposed to noise on a daily basis, and noise pollution is increasingly becoming more intense, especially with more people living in the urban areas. Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide and of global public health concern. Preventing and treating CVDs requires a better understanding of the associated risk factors. There is emerging evidence that noise pollution, especially related to the various forms of transport, is likely a contributor to the pathogenesis and aggravation of CVDs. We review key epidemiological data that address the link between excessive noise exposure and CVDs in humans and present proposed pathophysiological mechanisms underlying this association.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"226 - 231"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47360592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Perceived stress plays an important role in the pathogenesis of cardiovascular diseases (CVDs). Their associations with CVDs in the Chinese population are less investigated. The present study aims to investigate the associations of perceived stress with well-defined CVDs in a population-based survey in Shenzhen, China. Methods: In the community-based survey, we recruited 2,287 participants aged 18 years and over from 8 communities in Shenzhen, China. Perceived stress was assessed using the modified Chinese version of the Perceived Stress Scale with 14 items and a five-point Likert scale. CVDs including coronary heart disease, heart failure, and atrial fibrillation were ascertained from electronic health records and confirmed by family physicians. Potential confounders included age, sex, educational attainment, occupation, smoking, and alcohol-drinking habits. Multivariable logistic regression models were employed to estimate the magnitude of the associations. Results: Overall, the average perceived stress score was 37.2 (standard error: 7.2 and range: 14–70) among the participants. The prevalence of CVDs was 2.7%. After controlling for age, sex, educational attainment, occupation, smoking, and alcohol-drinking habits, a higher perceived stress score was significantly associated with higher risks of CVDs (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.01–1.55). The associations were comparable among men (OR: 1.20, 95% CI: 1.01–1.43) and women (OR: 1.29, 95% CI: 1.02–1.63). We also examined the potential nonlinear relationship using restricted cubic spines and found that the relationship was almost linear. Conclusions: Our analysis showed that higher perceived stress was associated with higher risks of CVDs among adults. Future studies are warranted to clarify the biological mechanisms and shed light on these associations.
{"title":"Perceived stress and cardiovascular disease in a community-based population","authors":"Yasi Zhang, Aijie Zhang, Jianbang Xiang, Yi-qiang Zhan","doi":"10.4103/hm.hm_55_22","DOIUrl":"https://doi.org/10.4103/hm.hm_55_22","url":null,"abstract":"Background: Perceived stress plays an important role in the pathogenesis of cardiovascular diseases (CVDs). Their associations with CVDs in the Chinese population are less investigated. The present study aims to investigate the associations of perceived stress with well-defined CVDs in a population-based survey in Shenzhen, China. Methods: In the community-based survey, we recruited 2,287 participants aged 18 years and over from 8 communities in Shenzhen, China. Perceived stress was assessed using the modified Chinese version of the Perceived Stress Scale with 14 items and a five-point Likert scale. CVDs including coronary heart disease, heart failure, and atrial fibrillation were ascertained from electronic health records and confirmed by family physicians. Potential confounders included age, sex, educational attainment, occupation, smoking, and alcohol-drinking habits. Multivariable logistic regression models were employed to estimate the magnitude of the associations. Results: Overall, the average perceived stress score was 37.2 (standard error: 7.2 and range: 14–70) among the participants. The prevalence of CVDs was 2.7%. After controlling for age, sex, educational attainment, occupation, smoking, and alcohol-drinking habits, a higher perceived stress score was significantly associated with higher risks of CVDs (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.01–1.55). The associations were comparable among men (OR: 1.20, 95% CI: 1.01–1.43) and women (OR: 1.29, 95% CI: 1.02–1.63). We also examined the potential nonlinear relationship using restricted cubic spines and found that the relationship was almost linear. Conclusions: Our analysis showed that higher perceived stress was associated with higher risks of CVDs among adults. Future studies are warranted to clarify the biological mechanisms and shed light on these associations.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"262 - 266"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43823302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The definition of a psychosocial stressor and reactions to it is discussed in relation to individual and environmental factors. The relation of this model to psychophysiological stress reactions and regeneration, as well as its significance for cardiovascular diseases, is described. Three classes of psychosocial stressors (life changes, work conditions, and family conflicts) are then described in relation to cardiovascular illness and risk factors. Particular emphasis is on longitudinal studies of patients. Heart contractility and urinary adrenaline excretion are discussed in detail. Epidemiological data on psychosocial stressors and cardiovascular disease outcomes (mainly myocardial infarction) are also discussed.
{"title":"Psychosocial stressors in psychosomatic cardiology: A narrative review","authors":"T. Theorell","doi":"10.4103/hm.hm_26_22","DOIUrl":"https://doi.org/10.4103/hm.hm_26_22","url":null,"abstract":"The definition of a psychosocial stressor and reactions to it is discussed in relation to individual and environmental factors. The relation of this model to psychophysiological stress reactions and regeneration, as well as its significance for cardiovascular diseases, is described. Three classes of psychosocial stressors (life changes, work conditions, and family conflicts) are then described in relation to cardiovascular illness and risk factors. Particular emphasis is on longitudinal studies of patients. Heart contractility and urinary adrenaline excretion are discussed in detail. Epidemiological data on psychosocial stressors and cardiovascular disease outcomes (mainly myocardial infarction) are also discussed.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"211 - 218"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41288516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We review the aspects of obstructive sleep apnea (OSA), which is the most common respiratory disorder of sleep in China. Approximately 176 million people in China have apnea/hypopnea index ≥5/h, ranking first among the ten countries with the highest prevalence rates. Two-thirds of patients do not receive treatment at all or withdraw after only brief treatment in a survey nested in two centers in China. Drowsiness and progressive cognitive impairment related to OSA decrease work performance and add to workplace errors and accidents. Many patients with OSA remain undiagnosed. Untreated OSA increases the risk of developing cardiovascular diseases and metabolic diseases. Undiagnosed and untreated OSA patients place a great burden on healthcare costs and services, and thus enormous economic burdens across most countries across the world, due to the global epidemic of obesity, an important contributor to OSA. Continuous positive airway pressure is the first-line treatment for OSA in China; however, adherence levels are poor. Effective and less labor-intensive methods that improve adherence need to be further investigated. Traditional Chinese medicine and acupuncture are promising treatments but with unproven efficacy.
{"title":"A narrative review on obstructive sleep apnea in China: A sleeping giant in disease pathology","authors":"Yuxi Wei, Yu Liu, N. Ayas, I. Laher","doi":"10.4103/hm.hm_49_22","DOIUrl":"https://doi.org/10.4103/hm.hm_49_22","url":null,"abstract":"We review the aspects of obstructive sleep apnea (OSA), which is the most common respiratory disorder of sleep in China. Approximately 176 million people in China have apnea/hypopnea index ≥5/h, ranking first among the ten countries with the highest prevalence rates. Two-thirds of patients do not receive treatment at all or withdraw after only brief treatment in a survey nested in two centers in China. Drowsiness and progressive cognitive impairment related to OSA decrease work performance and add to workplace errors and accidents. Many patients with OSA remain undiagnosed. Untreated OSA increases the risk of developing cardiovascular diseases and metabolic diseases. Undiagnosed and untreated OSA patients place a great burden on healthcare costs and services, and thus enormous economic burdens across most countries across the world, due to the global epidemic of obesity, an important contributor to OSA. Continuous positive airway pressure is the first-line treatment for OSA in China; however, adherence levels are poor. Effective and less labor-intensive methods that improve adherence need to be further investigated. Traditional Chinese medicine and acupuncture are promising treatments but with unproven efficacy.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"232 - 241"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43547846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It is crucial to clinically differentiate true aneurysms from pseudoaneurysms. Here, we are reporting a case of postintervention, iatrogenic distal radial artery pseudoaneurysm, which was successfully managed surgically. The present case scenario signifies the clinical features of pseudoaneurysm and relevant discussion with early treatment needs for this iatrogenic complication.
{"title":"A case report of iatrogenic radial artery pseudoaneurysm: Avoidable complication with the need of early intervention","authors":"Anshuman Darbari, Rahul Sharma, Rahul Dev, Ruhi Sharma","doi":"10.4103/hm.hm_17_22","DOIUrl":"https://doi.org/10.4103/hm.hm_17_22","url":null,"abstract":"It is crucial to clinically differentiate true aneurysms from pseudoaneurysms. Here, we are reporting a case of postintervention, iatrogenic distal radial artery pseudoaneurysm, which was successfully managed surgically. The present case scenario signifies the clinical features of pseudoaneurysm and relevant discussion with early treatment needs for this iatrogenic complication.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"282 - 284"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47681700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spontaneous coronary artery dissection (SCAD) is the acute development of a false lumen within the coronary artery wall by the spontaneous formation of an intramural hematoma which may compromise coronary (blood) flow by compression of the true lumen. Psychological factors have been implicated in its pathophysiology, but a synthesis of available data has not been previously undertaken. A literature search was conducted with the terms coronary artery dissection or spontaneous coronary artery dissection AND the terms psychological stress, anxiety, or depression. Initial studies in the field reported that psychological stress, anxiety, or depression was associated with SCAD and that acute stress may have a role in producing the SCAD. Recent studies with control groups of either acute coronary syndromes or acute myocardial infarction have produced discordant results. A meta-analysis of these studies, in this review, using a fixed effects model, showed that there was no significant association between SCAD and either moderate-to-high psychological stress or moderate-to-severe depression. However, one study reported that patients with SCAD were two-fold more likely to have experienced an emotional precipitant in the 24 h prior to the event. Assessment of patients with SCAD found long-term psychological consequences, and in some cases similar to posttraumatic stress disorder. In conclusion, chronic psychological stress, anxiety, or depression is not associated with the development of SCAD, however acute emotional stress may be a factor precipitating SCAD in some patients. Further research is necessary to examine the biological basis for SCAD and how acute stress might play a role in its pathogenesis.
{"title":"Does psychosocial stress lead to spontaneous coronary artery dissection? A review of the evidence","authors":"S. Rabkin","doi":"10.4103/hm.hm_36_22","DOIUrl":"https://doi.org/10.4103/hm.hm_36_22","url":null,"abstract":"Spontaneous coronary artery dissection (SCAD) is the acute development of a false lumen within the coronary artery wall by the spontaneous formation of an intramural hematoma which may compromise coronary (blood) flow by compression of the true lumen. Psychological factors have been implicated in its pathophysiology, but a synthesis of available data has not been previously undertaken. A literature search was conducted with the terms coronary artery dissection or spontaneous coronary artery dissection AND the terms psychological stress, anxiety, or depression. Initial studies in the field reported that psychological stress, anxiety, or depression was associated with SCAD and that acute stress may have a role in producing the SCAD. Recent studies with control groups of either acute coronary syndromes or acute myocardial infarction have produced discordant results. A meta-analysis of these studies, in this review, using a fixed effects model, showed that there was no significant association between SCAD and either moderate-to-high psychological stress or moderate-to-severe depression. However, one study reported that patients with SCAD were two-fold more likely to have experienced an emotional precipitant in the 24 h prior to the event. Assessment of patients with SCAD found long-term psychological consequences, and in some cases similar to posttraumatic stress disorder. In conclusion, chronic psychological stress, anxiety, or depression is not associated with the development of SCAD, however acute emotional stress may be a factor precipitating SCAD in some patients. Further research is necessary to examine the biological basis for SCAD and how acute stress might play a role in its pathogenesis.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"219 - 225"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49377119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sleep is a universal biological function but remains poorly understood and a relatively new field of science and medicine. Over the past decade, there have been rapidly accumulating scientific and clinical data around sleep, including the effects of various sleep aspects on cardiovascular health. Much of the research in the field has focused on sleep-disordered breathing, particularly obstructive sleep apnea. However, other sleep pathologies including hypersomnolence disorders, sleep-related movement disorders, and parasomnia disorders have been linked with cardiovascular health. Other areas of sleep, such as sleep duration, timing, and circadian rhythms, also have a demonstrated association with heart health. In this review, we provide an updated summary of the literature connecting sleep and cardiovascular disease.
{"title":"Impact of Sleep on Cardiovascular Health: A Narrative Review","authors":"O. Sum-ping, Y. Geng","doi":"10.4103/hm.hm_29_22","DOIUrl":"https://doi.org/10.4103/hm.hm_29_22","url":null,"abstract":"Sleep is a universal biological function but remains poorly understood and a relatively new field of science and medicine. Over the past decade, there have been rapidly accumulating scientific and clinical data around sleep, including the effects of various sleep aspects on cardiovascular health. Much of the research in the field has focused on sleep-disordered breathing, particularly obstructive sleep apnea. However, other sleep pathologies including hypersomnolence disorders, sleep-related movement disorders, and parasomnia disorders have been linked with cardiovascular health. Other areas of sleep, such as sleep duration, timing, and circadian rhythms, also have a demonstrated association with heart health. In this review, we provide an updated summary of the literature connecting sleep and cardiovascular disease.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":"6 1","pages":"120 - 126"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48532292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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