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Letter to the Editor| Volume 109, ISSUE 2, P277-279, May 10, 2006

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Triggering of cardiovascular incidents by micturition and defecation

      Although it is a commonly held belief that micturition and defecation can precipitate the onset of acute cardiovascular diseases, such circumstances remain among the most poorly investigated possible external triggers. Earlier observational studies have related toilet activities to the onset of acute pulmonary thromboembolism (APTE) [
      • Thames M.D.
      • Alpert J.S.
      • Dalen J.E.
      Syncope in patients with pulmonary embolism.
      ,
      • Kollef M.H.
      • Neelon-Kollef R.A.
      Pulmonary embolism associated with the act of defecation.
      ], acute myocardial infarction [
      • Tofler G.H.
      • Stone P.H.
      • Maclure M.
      • et al.
      Analysis of possible triggers of acute myocardial infarction (the MILIS Study).
      ,
      • Hayashi S.
      • Toyoshima H.
      • Tanabe N.
      • et al.
      Activity immediately before the onset of non-fatal myocardial infarction and sudden cardiac death.
      ,
      • Čulić V.
      • Mirić D.
      • Eterović D.
      Different circumstances, timing, and symptom presentation at onset of Q wave versus non-Q wave acute myocardial infarction.
      ], sudden cardiac death [
      • Hayashi S.
      • Toyoshima H.
      • Tanabe N.
      • et al.
      Activity immediately before the onset of non-fatal myocardial infarction and sudden cardiac death.
      ] and subarachnoidal hemorrhage [
      • Schievink W.I.
      • Karemaker J.M.
      • Hageman L.M.
      • van der Werf D.J.
      Circumstances surrounding aneurysmal subarachnoid hemorrhage.
      ]. In the February issue of the journal, an interesting study by Yamada et al. [
      • Yamada N.
      • Nakamura M.
      • Ishikura K.
      • et al.
      Triggers of acute pulmonary thromboembolism developed in hospital, with focusing on toilet activities as triggering acts.
      ] further described clinical features of these external triggers and reported their frequent occurrence before the onset of APTE among Japanese patients.
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      References

        • Thames M.D.
        • Alpert J.S.
        • Dalen J.E.
        Syncope in patients with pulmonary embolism.
        JAMA. 1977; 238: 2509-2511
        • Kollef M.H.
        • Neelon-Kollef R.A.
        Pulmonary embolism associated with the act of defecation.
        Heart Lung. 1991; 20: 451-454
        • Tofler G.H.
        • Stone P.H.
        • Maclure M.
        • et al.
        Analysis of possible triggers of acute myocardial infarction (the MILIS Study).
        Am J Cardiol. 1990; 66: 22-27
        • Hayashi S.
        • Toyoshima H.
        • Tanabe N.
        • et al.
        Activity immediately before the onset of non-fatal myocardial infarction and sudden cardiac death.
        Jpn Circ J. 1996; 60: 947-953
        • Čulić V.
        • Mirić D.
        • Eterović D.
        Different circumstances, timing, and symptom presentation at onset of Q wave versus non-Q wave acute myocardial infarction.
        Am J Cardiol. 2002; 89: 456-460
        • Schievink W.I.
        • Karemaker J.M.
        • Hageman L.M.
        • van der Werf D.J.
        Circumstances surrounding aneurysmal subarachnoid hemorrhage.
        Surg Neurol. 1989; 32: 266-272
        • Yamada N.
        • Nakamura M.
        • Ishikura K.
        • et al.
        Triggers of acute pulmonary thromboembolism developed in hospital, with focusing on toilet activities as triggering acts.
        Int J Cardiol. 2005; 98: 409-411
        • Čulić V.
        Triggering of sudden cardiac events by coffee and alcohol consumption: what do we know?.
        Croat Med J. 2005; 46: 150-151
        • Čulić V.
        • Eterović D.
        • Mirić D.
        Meta-analysis of possible external triggers of acute myocardial infarction.
        Int J Cardiol. 2005; 99: 1-8
        • Mittleman M.A.
        • Maclure M.
        • Tofler G.H.
        • Sherwood J.B.
        • Goldber R.J.
        • Muller J.E.
        • for the Determinants of Myocardial Infarction Onset Study Investigators
        Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion.
        N Engl J Med. 1993; 329: 1677-1683
        • Mittleman M.A.
        • Maclure M.
        • Sherwood J.B.
        • et al.
        • for the Determinants of Myocardial Infarction Onset Study Investigators
        Triggering of acute myocardial infarction onset by episodes of anger.
        Circulation. 1995; 92: 1720-1725
        • Kaufmann H.
        • Hainsworth R.
        Why do we faint?.
        Muscle Nerve. 2001; 24: 981-983
        • Sharpey-Schafer E.P.
        Effects of Valsalva's manoeuvre on the normal and failing circulation.
        Br Med J. 1955; 1: 693-695
        • Musial F.
        • Musial A.
        • Kalveram K.T.
        • Enck P.
        • Crowell M.D.
        Influence of continuous, isobaric rectal distention on smooth muscle tone and cardiovascular activation in healthy volunteers.
        Folia Med Cracov. 1999; 40: 107-114
        • Čulić V.
        • Eterović D.
        • Mirić D.
        • Giunio L.
        • Lukin A.
        • Fabijanić D.
        Triggering of ventricular tachycardia by meteorological and emotional stress. Protective effect of β-blockers and anxiolytics in men and elderly.
        Am J Epidemiol. 2004; 160: 1047-1058
        • Larcan A.
        • Lambert H.
        • Stoltz J.F.
        • Laprevote-Heuilly M.C.
        • Kempf J.B.
        • Lambert J.
        Climatological parameters and acute vascular, neurologic and cardiac accidents.
        Rev Epidemiol Sante Publique. 1982; 30: 343-354
        • Woodhouse P.R.
        • Khaw K.T.
        • Plummer M.
        • Foley A.
        • Meade T.W.
        Seasonal variation of plasma fibrinogen and factor VII activity in the elderly: winter infections and death from cardiovascular disease.
        Lancet. 1994; 343: 435-439
        • Čulić V.
        • Eterović D.
        • Mirić D.
        • Rumboldt Z.
        • Hozo I.
        Gender differences in triggering of acute myocardial infarction.
        Am J Cardiol. 2000; 85: 753-756