应激对心血管影响_重点.ppt

Adverse Effects of Acute Emotional Stress on the Heart Left Ventricular Dysfunction(Stress Cardiomyopathy or Takotsubo Cardiomyopathy) Typically occurs in an older woman. Sudden chest pain and shortness of breath occurs soon after an emotionally stressful or traumatic experience. Left ventricular dysfunction most prominently affects the cardiac apex. Effects of high levels of catecholamines have been implicated. Myocardial Ischemia Systemic vascular resistance increases during mental or emotional stress although myocardial oxygen demand also increases. Individuals with coronary artery disease may develop myocardial ischemia during emotional or mental stress even if their exercise or chemical nuclear stress test results are negative. Ventricular Arrhythmias At least 20% of episodes of serious ventricular arrhythmias or sudden cardiac death are precipitated by intense or unusual emotional stress. Intense emotions may lead to particularly lethal ventricular arrhythmias. Asymmetric brain activity may produce areas of inhomogeneous ventricular repolarization that create electrical instability in the heart. PREVENTING AND MANAGING STRESS ? Avoid situations that you know will cause stress. ? Incorporate some type of exercise into each day. ? Eat a healthful diet rich in fruits, vegetables, and whole grains. ? Do not smoke. ? Use alcohol only in moderation. ? Quiet time, meditation, prayer, reading, yoga, and relaxation techniques (including biofeedback) can help in stress management. ? Family and friends can provide needed support. Talking about problems can help to reduce conflict and express feelings. ? If you have heart disease, your doctor may prescribe a beta-blocker, a type of medication to help lower the heart rate and control abnormal heart rhythms. 临床医学专业八年制卫生部规划教材 《病理生理学》 第2版 急慢性心理应激对心血管系统的影响 目前认为，应激是机体在受到内外环境因素及社会、心理因素(统称为应激原)刺激时所出现的非特异性全身性适应反应，也称应激反应（stress response)。 应激 凡能引起应激反应的各种刺激因素称为应激原。 种类： 1.外环境因素 2.内环境因素 3.心理、社会因素 高热、寒冷、射线、噪声、强光、低氧、病