-Caveat Lector-

Tuesday March 9 12:56 PM ET
(Maybe I'm must suspicious and perhaps even paranoid, but I have to
wonder about the timing of this article. --SW)

Bad Hearts and Stress Can Be Deadly

By DANIEL Q. HANEY AP Medical Editor

NEW ORLEANS (AP) - Speaking in public may be more than just terrifying.
The stress may be deadly.

A study released Tuesday found that people whose hearts show ominous
signs of poor circulation during such mental challenges face triple the
usual risk of death in the years to come.

Often people with bad hearts suffer chest pain during exertion. Their
clogged arteries cannot supply enough blood to their heart muscle. But
over the past decade, it has become clear that mental exertion can also
overwork the heart, although often without pain. Doctors call this
condition silent ischemia.

While doctors assume that silent ischemia is not a good thing, no studies
until now have been large enough to prove that mental stress can
actually be fatal for people with coronary artery disease.

The latest study demonstrates just how dangerous this can be for the heart.
It found the annual death rate is about 4 percent among people
whose hearts have bad circulation during mental stress. This is more than
triple the risk faced by heart disease patients who do not react this
way to mental stress.

In the study, the researchers found that public speaking is a particularly
potent trigger of this heart problem. However, they said that probably
anything that causes mental stress is risky for these people.

The study, conducted by Dr. David S. Sheps of East Tennessee State
University, was presented in New Orleans at a meeting of the American
College of Cardiology.

``As doctors, we all have had patients for whom we have no doubt that an
acutely stressful situation has precipitated a cardiac event,'' Sheps
said.

To help understand how this happens, the researchers gave three days of
tests to 173 men and women with heart disease. They were asked to
imagine that a relative had been mistreated in a nursing home. Then they
were given two minutes to prepare a speech about the problem and
five minutes to deliver it before an audience.

People's blood pressure typically soared about 40 points. Radionucleotide
scanners watched their hearts. In half the volunteers, sections of the
muscle of the left ventricle began to beat erratically.

Eleven of them died during three to four years of follow-up. Forty-four
percent of these victims had shown the erratic heartbeats during public
speaking, while 18 percent did not.

Sheps said those whose hearts reacted badly on the test seemed no more
nervous or tongue-tied than those who weathered the stress without
problems.

``Most people do not have sudden death during public speaking,'' noted Dr.
Bernard Gersh of the Mayo Clinic. Instead, the study identified
people with a heightened response to stresses that may lead to a heart
attack.

Earlier studies have shown that such hardships as depression, the death of
a spouse, losing a job or living through an earthquake increase the
risk of fatal heart attacks.

However, those studies did not test victims ahead of time for silent
ischemia during mental stress.

The study was financed by the National Heart, Lung and Blood Institute.
------------------------------------------------------------------------
Steve Wingate

California Director
SKYWATCH INTERNATIONAL

TODAY'S MP3: The Bureau: Take to the Sky
http://www.mp3.com/music/Jazz/11448.html

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