Dr. Steven Reisman, a New York City cardiologist, will discuss the relationship between acute risk factors or acute triggers and the development of a heart attack or stroke. It is well known that there are chronic risk factors for heart disease such as hypertension, hyperlipidemia, diabetes mellitus, smoking, and other factors. There are also acute risk factors that can precipitate a cardiac event. Acute risk factors may result in a rapid increase in blood pressure, vasoconstriction, or even increase in coagulability.

There are several psychological triggers that are known to play a role. These include anger, emotional upset, anxiety, stress in the work place, bereavement, and sexual activity.

An interesting phenomenon has been observed that showed a significant increase in heart attacks at 9 am in the morning. It appears that the act of waking up, when a person who is vulnerable to a heart attack, goes from a supine to an upright position increases the catecholamines in the body. These particular individuals most likely have an underlying plaque that is vulnerable and is more likely to clot in the morning.

There are physical triggers that can include vigorous physical activity along with sexual activity. These factors play a bigger role in those who are sedentary and a lesser role in those who have the habit of exercising on a regular basis.

There are psychological stresses which include an outburst of anger which elevates the risk of heart attack. Also, episodes of anxiety can increase the risk of a heart attack. In addition, depression and frustration may also be associated with increasing the risk of a heart attack.

There are also population stresses that can increase the risk of a heart attack such as earthquakes, war, and even elevated pollution levels and respiratory infection and also floods.

Dr. Steven Reisman, a New York City cardiologist and director of the New York Cardiac Diagnostic Center feels that an initial evaluation with a cardiologist in consultation to evaluate risk of a heart attack along with proper exercise and treatment of psychological stress and prevention of psychological stress is key to helping diminish the risk of heart attack and stroke in these individuals.