DETERMINING THE ASSOCIATION OF PERSONALITY TRAITS WITH PAIN PERCEPTION THRESHOLD IN THE CASE OF DUMP ISCHEMIA INDUCED BY PHYSICAL STRESS TEST
DOI:
https://doi.org/10.52340/jecm.2022.06.19Keywords:
Personality, physical stress, dumb ischemia, associationAbstract
The aim of the study was to determine the association of personality character traits with the pain perception threshold in the case of dumb ischemia induced by cold stress test.
Materials: We examined 58 patients on the basis of the therapeutic clinic of the Georgian Patriarchate. Patients were divided into three groups: Group I - with various somatic pathologies, Group II with unstable angina and Group III - Persons obsessed with neurocirculatory dystonia.
Methods: I. Characteristic features of patients were studied using the Eysenck Questionnaire: This questionnaire assesses the degree of extroversion and introversion and the level of neuroticism. II - Determination of pain perception threshold by heat method, standard cold test. Cold test was performed on 8 patients of group I, 10 patients of group II and 7 patients of group III.
Discussion: It has finally been established that under conditions of the same degree of occlusion of the coronary arteries, both painful and painless episodes of ischemia can occur. Our study showed that patients with asymptomatic ischemia detected by physical stress test showed an increase in pain perception threshold after treatment with anaprilin and isosorbide dinitrate. Treatment with diltiazem does not affect the pain perception threshold.
Conclusion: According to our study, patients who have dumb ischemia are prone to introversion and low neuroticism. This tendency is best seen from the contrast between personality traits and pain threshold. Patients with episodes of asymptomatic ischemia and a high threshold for pain perception respond to cold-induced sympathetic stimulation with a weakened hemodynamic response, in contrast to those with health and unstable angina pectoris.
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Anderson KL, Shah NA, Gallegos M, Chiang IH. Asymptomatic ST elevation. Heart Lung. 2018 Jul - Aug; 47(4):363-365.
Choi KH, Lee JM, Park I, Kim J, Rhee TM, Hwang D, Park J, Park TK, Yang JH, Song YB, Hahn JY, Jeong DS, Cho YH, Kim WS, Sung K, Jang MJ, Sung JD, Choi JH, Choi SH, Koo BK, Lee YT, Kim EK, Chang SA, Park SJ, Choi JO, Lee SC, Park SW, Cho YS, Choi JY, Gwon HC, Oh JK. Comparison of long-term clinical outcomes between revascularization versus medical treatment in patients with silent myocardial ischemia. Int J Cardiol. 2019 Feb 15; 277:47-53.
Christensen, M.K.; Smith, D.F. Antinociceptive effects of the stereoisomers of nicotine given intrathecally in spinal rats. Journal of Neural Transmission. General Section 80(3): 189-194, 1990
Deedwania PC, Nelson JR. Pathophysiology of silent myocardial ischemia during daily life. Hemodynamic evaluation by simultaneous electrocardiographic and blood pressure monitoring. Circulation. 1990 Oct;82(4):1296-304. doi: 10.1161/01.cir.82.4.1296. PMID: 1976049.
Kanorskii SG, Smolenskaya NV. [Triple antianginal combinations in the treatment of elderly and senile patients with stable angina]. Ter Arkh. 2016; 88(12):33-40.
Kavtaradze GV. Osobennosti mekhanizmov psikhologicheskoĭ adaptatsii bol'nykh ishemicheskoĭ bolezn'iu serdtsa i gipertonicheskoĭ bolezn'iu [Characteristics of the mechanisms of psychological adaptation of patients with ischemic heart disease and hypertension]. Kardiologiia. 1986 Mar; 26(3):68-72. Russian. PMID: 3712939.
Levenson JL, Mishra A, Hamer RM, Hastillo A. Denial and medical outcome in unstable angina. Psychosom Med. 1989 Jan-Feb; 51(1):27-35. doi:10.1097/00006842-198901000-00003. PMID: 2784580.
Malhotra S, Sharma R, Kliner DE, Follansbee WP, Soman P. Relationship between silent myocardial ischemia and coronary artery disease risk factors. J Nucl Cardiol 2013.
Murphy BM, Worcester MU, Goble AJ, Mitchell F, Navaratnam H, Higgins RO, Elliott PC, Le Grande MR. Lifestyle and physiological risk factor profiles six weeks after an acute cardiac event: are patients achieving recommended targets for secondary prevention? Heart Lung Circ. 2011 Jul; 20(7):446-51.
Nabel EG, Rocco MB, Barry J, Campbell S, Selwyn AP. Asymptomatic Ischemia in Patients with Coronary Artery Disease. JAMA. 1987; 257(14):1923-1928. doi:10.1001/jama.1987.03390140093034
Nicholls SJ, Nelson AJ. HDL and cardiovascular disease. Pathology. 2019 Feb; 51(2):142-147.
Petretta, M., Fiumara, G., Petretta, M.P. et al. Detection of silent myocardial ischemia: Is it clinically relevant? Journal of Nuclear Cardiology, 2013, 20, 707-710.
Sheps DS, Maixner W, Hinderliter AL. Mechanisms of pain perception in patients with silent myocardial ischemia. Am Heart J. 1990 Apr; 119(4):983-7. doi:10.1016/s0002-8703(05)80351-5. PMID: 2157331.
Vancheri F, Longo G, Vancheri S, Henein M. Microvascular Dysfunction. J Clin Med. 2020 Sep 6; 9(9):2880.
Wimmer NJ, Scirica BM, Stone PH. The clinical significance of continuous ECG (ambulatory ECG or Holter) monitoring of the ST-segment to evaluate ischemia: a review. Prog. Cardiovasc Dis. 2013 Sep-Oct; 56(2):195-202.
Zhdan VM, Holovanova IA, Filatova VL, Khorosh MV. Medical evaluation of efficiency of optimized models for early detection and primary prevention of cardiovascular diseases. Wiad Lek. 2017; 70(3 pt 1):433-438.
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