Cortisol can cause AMI?

[Bloom-IUEMT]

Could someone help out with a question:
Got into a disagreement with "friend" about stress being in and of itself sufficient to cause an AMI. I thought not possible...there has to be medical condition along with stress like some sort of cardiomyopathy, arteriosclerosis, atherosclerosis, or some sort of coronary artery stenosis to cause ischemia. I've never heard of stress BY ITSELF causing an AMI.
Well my roommate informs me his physio prof says its the high levels of cortisol in the blood that causes the MI. My question is how is that possible?

Its seems as though any amount of increased heart rate would cause sinus tachy or SVT before its caused MI. I've done a really brief search of academic journals through Academic Search Premier and came up with no evidence indicating cortisol BY ITSELF causes AMI in pts with no hx. One article alluded to cortisol causing an inflammatory response so that looks promising......

Just wondered if anyone has heard this or has been taught this in physio (never taken it) and if I'm just ill-informed. Thanks

 

[daedalus]

I think you are probably right. Stress and disease are related certainly, but underlying conditions such as hypertension, bad genetics, hyperlipidemia, DM, obesity, etc are going to be present because they also contribute to the pathological processes that is an MI.

Cortisol itself? Highly doubt it.

 

[Shishkabob]

Well, it's well known that stress causes hypertension, which is one of the components.

 

[LucidResq]

Stress increases levels of cortisol. Cortisol increases salt and water retention, raising BP. Long term increased levels of cortisol can lead to hypertension, then heart disease, and then an increased risk of MI.

Emotional stress and increased levels of cortisol are also suspected as an acute trigger of MI. Cortisol levels follow a non-stress-related pattern that follows circadian rhythms. Blood cortisol levels peak in the morning right before one wakes, and are lowest around bedtime.

 

[Smash]

Your friend may be referring to Takotsubo syndrome, or Broken-Heart disease.

Takotsubo is a stress induced cardiomyopathy thought to be related to catecholamine toxicity. It causes apical ballooning (hence the name takotsubo which refers to a pot for catching squid in that is the same shape) and closely mimics ACS with chest pain, troponin rise (although usually small) and LVF in some cases. It was first described amongst Japanese widowers.