Cardiovascular Effects of an Earthquake

Abstract

Abstract-The increased cardiovascular mortality during an earthquake has been related, among other factors, to a sympathetically mediated increase in heart rate and blood pressure. However, this is supported only by indirect evidence collected after an earthquake, whereas for obvious technical difficulties, no data are available on the acute blood pressure and heart rate effects during an earthquake. In a patient undergoing 24-hour ambulatory blood pressure monitoring (Spacelabs 90207), we had the opportunity to directly record the acute blood pressure and heart rate changes induced by an earthquake (magnitude 4.7 according to the Richter scale) that struck central Italy in March 1998. Systolic blood pressure rose to 150 mm Hg, diastolic blood pressure rose to 122 mm Hg, and heart rate rose to 150 bpm at the time of the strongest tremor. Prequake blood pressure levels were restored only 1 hour later, but blood pressure remained characterized by a pronounced variability throughout the following 6 hours. Thus, a sympathetically mediated combined increase in blood pressure and heart rate may represent an important pathophysiological mechanism responsible for the increased frequency of cardiovascular events during an earthquake. The associated increase in blood pressure variability might further contribute to the increase in cardiovascular risk typical of this condition. Our case report further supports the usefulness of ambulatory blood pressure monitoring to assess the blood pressure and heart rate effects of sudden daily life events, the actual cardiovascular impact of which can hardly be quantified through traditional measurements.

Occurrence of Cardiovascular Events After the 2011 Great East Japan Earthquake and Tsunami Disaster

“…28) The activation of these systems may provoke increases in blood pressure, 29) heart rate, 21,30) catecholamine level, 31) vascular tone, 28) and platelet activation 32,33) which could enhance vascular spasm, injury, formation of platelet-rich thromboli, and potential subsequent rupture of a vulnerable atherosclerotic plaque. 34,35) As a result, cardiovascular events including ACS often significantly increase in the period following an earthquake.…”

“…Many factors such as increases in heart rate, 21,30) blood pressure 29) or catecholamine levels 31) may provoke CHF or cause its deterioration after a major earthquake. However, there is little information concerning CHF caused by sudden emotional or physical stress due to a large earthquake.…”

O Hipotálamo Dorsomedial E a Organização Da Resposta Cardiovascular Ao Estresse Emocional: Uma Perspectiva Funcional

“…Mais recentemente, estudos em humanos mostraram que agentes estressores de grande impacto produziram aumento sustentado na pressão arterial 6,7 . Adicionalmente, Davies et al 8 demonstraram uma relação entre a desordem do pânico e a hipertensão.…”

“…No entanto, situações de estresse repetidas ou prolongadas podem resultar em vários estados patológicos, como a hipertensão arterial, arritmias cardíacas, infarto do miocárdio e até mesmo a morte súbita 3,4,5 . Interessantemente, estudos recentes em humanos mostram que um aumento sustentado da pressão arterial pode ocorrer na presença de situações de estresse exacerbado 6,7 . Além disso, outros distúrbios do estresse, como o transtorno do pânico, apresentam uma correlação positiva com a hipertensão essencial 8 .…”

Earthquake and blood pressure

“…Parati et al 8 were the first to report a patient undergoing 24-h ambulatory blood pressure monitoring during an earthquake. Their patient experienced an acute 20% increase in systolic blood pressure and an acute 79% increase in heart rate.…”