A

Emotional - Physical
Stress
Medu~ary a1Jtonomlo: c.en1re .ict.Va1iof'I

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Microvascular spasm

--~---i Myoc..rdial stunning

Sy-mpat~licoulflow

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½ b.•;.;,;.;;.- -.
~ull<1ry
release
I {'J.._.._
I
1 t \
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1 sttmula1,on v•s.o~onstnctoon __ 1~Sed ___
Ep,nephrintrtl!ase waUsuess

f Ncrtpintphrine
LIii# f
....,......-- -
t I
N~fOhormonail Ktivily
(ndo1helin levt4s
Epinephrine

1 - - - - - - - - Phase 1 - - - - - - - - - l Phase 2 - - - - - - - i
Activation of the hypothalamic - pituitary - adrenal axis Myocardial dysfunction

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B

l
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