Cardiac sequelae in Brooklyn after the September 11 terrorist attacks

Abstract

Background: Terrorism, such as the attacks on the World Trade Center (WTC) on September 11,2001, result in higher stress‐related disorders, especially in those persons in close proximity. Hypothesis: Cardiac events resulting from the September 11,2001 tragedy have not been detailed near the WTC. Methods: Patients admitted to the Telemetry and Coronary Care Units at New York Methodist Hospital 4 miles from the WTC 60 days prior to and after the September 11 attacks were analyzed. In all, 1,653 admissions were reviewed: 427 records pre 9/11/2001 and 422, 393, and 411 records in the post‐9/11/2001, pre‐9/11/2000, and post‐9/11/2000 data sets, respectively. Patients were categorized based on diagnosis: acute myocardial infarction (MI), unstable angina (UA), tachyarrhythmia (TA), and others (including syncope and congestive heart failure). Results: There was a significant difference in the proportion of the various cardiac diagnoses post 9/11/01 (p = 0.008 by chi‐square analysis). Compared with pre 9/11/2001, there were significantly more patients with acute MI (15.5 vs. 11.2%) and TA(19.9vs. 13.6%)but fewer with UA(39.6vs. 47.3%)after the terrorist attacks. The distribution of cardiac events during a similar period of time in 2000 revealed no such pattern. Conclusions: There was a significant increase in acute MI and TA and a smaller increase in UA after the September 11 attacks. The difference did not appear to be due to temporal variation. It appears that stress likely contributed to an increase in TA by itself or with ischemia, resulting in progression of UA to acute MI.

Mental Health Consequences of September 11: A Five-Year Review of the Behavioral Sciences Literature

“…Twelve percent of patients experienced a worsening of seizures in the immediate aftermath of 9/11. This study substantiates findings in other studies by Ho et al, 2002 andFeng et al, 2006 demonstrating a strong correlation between physical and psychological stress.…”

“…This finding was ascertained by reviewing medical records of 1,653 hospital admissions at New York Methodist Hospital in the two months before and after September 11. This study demonstrates that a strong correlation exists between physical and psychological stress (Feng et al 2006).…”

Health status and health care utilization following collective trauma: A 3-year national study of the 9/11 terrorist attacks in the United States

“…Physical health outcomes received substantially less attention, although some research found that survivors and rescue workers in New York reported many physician-diagnosed physical health problems both immediately (Feng, Lenihan, Johnson, & Reddy, 2006;Lampert, Baron, McPherson, & Lee, 2002;Steinberg et al, 2004) and as long as 5 years after 9/11 (Brackbill et al, 2006;Wheeler et al, 2007). Indeed, a growing body of research suggests extremely stressful events may trigger biological processes that increase an individual's risk of developing various health ailments (e.g., gastrointestinal, musculoskeletal, neurological;McEwen, 1998;Pizarro, Silver, & Prause, 2006;Schnurr & Green, 2004).…”

Military Sexual Trauma Exposure and Heart Rate Variability Outcomes in Female Veterans

“…The year following the 9-11 terrorist attack, there were significantly more admissions (p = .008) with MI and tachyarrhythmias based on a retrospective review of charts (n = 1,653) at a hospital within four miles of the disaster site (Feng, Leniham, Johnson, Karri, & Redd, 2006). In a probability sample (n = 2,729, 52.2% female) from the National Health Interview Survey, there was increased relative risk of heart problems nationally at one (2.98, 95% CI = 1.19-7.49, p < .05), two (3.12, 95% CI = 1.37-7.12, p < .01), and three (1.38, 95% CI = 0.55-3.41, p < .001) years following the 9-11 terrorist attack (Holman et al, 2008).…”