Triggers of Nonfatal Myocardial Infarction in Costa Rica: Heavy Physical Exertion, Sexual Activity, and Infection

Abstract

The incidence of coronary heart disease is increasing in developing countries undergoing socioeconomic transition(1). Lifestyles in many of these countries are dramatically different from those in Europe and the United States. For ex-ample, vigorous physical activity is more likely to be related to work than to recreational activities(2). The pattern of acute infections also is distinct, with a greater incidence than in developed countries. In addition, because transition countries are characterized by the presence of both infectious and chronic disease (3), the study of gastroenteritis episodes as a trigger of myocardial infarction (MI) is of particular interest in these countries. Cardiovascular disease (CVD) as a major health problem was established only recently in transition societies, and very few studies examined factors affecting CVD in the context of these different lifestyles(4).