Hemodynamic response to different types of mental stress in patients with recent myocardial infarction

The purpose of this study was to analyze the cardiovascular effects induced by mental stress evoked by different stressors in patients with recent uncomplicated myocardial infarction. Twenty four males, aged 52 ± 10 years, were studied 45 ± 22 days after uncomplicated myocardial infarction in the absence of specific cardiovascular drugs. During electrocardiographic and hemodynamic monitoring with a Swan-Ganz catheter the patients underwent 4 different stressors: mental arithmetic, Sacks test, Raven progressive matrices, white noise. All hemodynamic parameters were significantly (p <0.001) modified by 3 of the 4 stressors, while noise significantly affected (p <0.005) only blood pressure. Mental arithmetic was more powerful in inducing hemodynamic effects than either the Sacks test or the Raven matrices. Thus, experimentally induced mental stress challenges the recently infarcted patient's cardiovascular system to a quantifiable extent, causing important increments in left ventricular filling pressure. Hemodynamic response is different depending on the stressor employed.