Acute Behavioral and Psychosocial Triggers of Myocardial Infarction

Of the numerous causes of myocardial infarction (MI), a salient group of triggers are acute and occur within 24 h of the onset of MI. After presenting the pathophysiology of MI, this chapter then provides an illustrative account of the literature that reports on the risk of MI attributable to these acute triggers. Behavioral triggers include physical activity, sexual activity, alcohol use, cigarette smoking, substance use, and sleep disturbances; psychological triggers are divided into environmental factors (natural disasters, sporting events, and war) and psychological triggers (acute emotional distress, bereavement, work stress, and anger). Finally, we examine methodological considerations in the interpretation of these results; asymptomatic, silent MI may not even be measured, and recall bias may make attributing a specific trigger to the MI difficult. To better understand this phenomenon, further research can provide new perspectives on how triggers are measured, such as gauging the intensity of the trigger.