明確な心身相関を呈した血圧変動の著名な冠動脈疾患の1例

概要

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Recently, many diseases are considered as psychosomatic diseases, however, few cases present the manifest correlation of clinical and psychological findings. We reported a case of coronary artery disease whose clinical manifestations varied depending on emotional stresses. A local physician referred to us a 76-year-old female patient complaining of severe headache and hypertension. Before then, she had been definitive in diagnosing coronary artery disease on the basis of coronary angiography, and had undergone A-C bypass operation. But after the operation, she came to experience attacks of severe headache accompanied by the elevation of blood pressure. Physical examinations showed no abnormalities causing the headache, so a diagnosis of psychogenic headache was suspected. After the admission to our hospital, her subjective symptoms and blood pressure varied depending on emotional stresses on three different occasions. These stresses were brought on by the therapist when he interpreted her conflict and just before her expectated date of leaving the hospital. When the interpretation was given, the emotional stress brought about the elevation of blood pressure and acute heart failure. A case of coronary artery disease with fluctuating blood pressure was documented and the etiology of the disease was discussed. This case clearly presents that emotional stress significantly impairs the fluctuations of blood pressure.
日本心身医学会の論文
1993-06-01