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Previous Volume 352:1923-1925 May 5, 2005 Number 18 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Wittstein et al. (Feb. 10 issue)¹ report a marked elevation of circulating markers of sympathetic stimulation, including neuropeptide Y, and raise the possibility of direct, catecholamine-induced myocardial stunning. Notable features of this syndrome are a presentation with chest pain and reversible electrocardiographic (ECG) abnormalities, which strongly suggest that severe, persistent myocardial ischemia is a cause of prolonged stunning.

Persistent, deep, negative T waves and reversible Q waves are common in patients with variant angina after very prolonged coronary spasm.² In persons with stress-induced myocardial stunning, epicardial coronary-artery spasm has been documented angiographically by chance³ and after provocative . . . [Full Text of this Article]

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