Acute Cardiovascular Events Triggered by COVID-19-Related Stress

The onset of acute myocardial infarction (AMI) is a complex interplay of internal circadian
factors and external physical and emotional triggers. These interactions may lead to rupture
of an often non-occlusive vulnerable atherosclerotic coronary plaque with subsequent
formation of an occlusive thrombus. Physical and emotional stresses are important triggers of
acute cardiovascular events including AMI. Triggering events, internal changes, and external
factors vary among different geographical, environmental, and ethnic regions. Life-style
changes, pharmacotherapy, and psychological interventions may potentially modify the response
to, and protect against the effects of triggering events. Certain times in the life span of
different communities all around the world are prone to natural and man-made disasters that,
not only have direct negative impact on human lives and state-resources, but also have
indirect impact on triggering acute cardiovascular events during the time of the disaster and
the period immediately after. For example, earthquakes, wars, and terrorist attacks, in
addition to direct human life loss and destruction of communities, have bees associated with
a surge in the number of acute MI, sudden cardiac death, ventricular tachy-arrhythmia and
implantable cardiovertor defibrillators (ICD) discharges.

The current COVID-19 pandemic has afflicted almost the whole globe. The virus can directly
attack the myocyte and cause various degrees of cardiac damage and cardiovascular clinical
entities. However, the stress related to the pandemic, not the direct virus-related injury,
can be potentially associated with acute cardiovascular events due to a large list of
physical and psycho-social stresses such as extreme physical effort, lock down, anger, fear,
financial stress, sorrow, death of a significant person..etc.

This study is a cross sectional study that will enroll patients evaluated during the COVID-19
pandemic period for acute cardiovascular events not directory related to the virus
infectivity, who voice certain and specific trigger(s) related to the pandemic impact on
social life and physical activity.