Mental stress-induced myocardial ischemia (MSIMI) is a medical condition in which acute psychological stress can trigger a transient myocardial ischemia, which is a state of reduced blood flow to the heart muscle, often without the presence of significant coronary artery disease (CAD).
[6] Mental stress triggers various physiological changes in the body, activating mechanisms such as the autonomic nervous system (ANS) and the hypothalamic–pituitary–adrenal axis (HPA), resulting in hemodynamic, neuroendocrine, and immune responses.
[5] Mental stress-induced myocardial ischemia involves abnormal microvascular vasoreactivity and inflammation, with increased brain activity in regions that modulate autonomic nervous system reactivity to emotional stress, fear.
[6] MSIMI can occur at lower cardiac workloads, independent of hemodynamic changes, and is not directly related to the severity of angiographic CHD.
[6] Current research focuses on understanding stress pathways in CAD and integrating mental health, behavioral medicine with routine cardiology care to improve patient outcomes.