Myocardial infarction is more common in the morning…
· Awakening and arising is associated with adrenergic stimulation
· Adrenergic stimulation leads to elevated blood pressure
· Elevated pressure increases the hemodynamic stress on atheromatous plaque
· This may lead to
a. Plaque rupture/fissuring
b. Plaque erosion/ulceration
· These events predispose the plaque to thrombose
· Thrombosis leads to coronary artery occlusion leading to MI
That is why the peak incidence of MI is between 6 a.m. and 12 noon
Same reason is applicable for MI following emotional stress…
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