To the Editor: The acute coronary syndromes — myocardialinfarction, unstable angina, and sudden cardiac death —have been shown to be triggered by heavy physical exertion,including snow shoveling,1 anger, and other types of emotionalor physical stress.2 Although the underlying mechanism has beenpostulated to be rupture of a vulnerable coronary plaque andthe development of intraluminal thrombus, such acute coronarychanges have not been demonstrated in living patients.
During the blizzard and subsequent snowstorms that affectedNew Jersey in 1996, 19 patients (16 men and 3 women; mean age,61 years [range, 40 to 78]; 9 with . . . [Full Text of this Article]
In Collaboration With the American College of Spor, , Thompson, P. D., Franklin, B. A., Balady, G. J., Blair, S. N., Corrado, D., Estes, N.A. M. III, Fulton, J. E., Gordon, N. F., Haskell, W. L., Link, M. S., Maron, B. J., Mittleman, M. A., Pelliccia, A., Wenger, N. K., Willich, S. N., Costa, F.
(2007). Exercise and Acute Cardiovascular Events: Placing the Risks Into Perspective: A Scientific Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation
115: 2358-2368
[Abstract][Full Text]
Thompson, P. D., Haft, J. I., Hammoudeh, A. J.
(1997). More on Coronary-Plaque Rupture Triggered by Snow Shoveling. NEJM
336: 1678-1679
[Full Text]
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