title: Acute myocardial infarction and stress cardiomyopathy following the Christchurch earthquakes.
abstract: BACKGROUND
  Christchurch, New Zealand, was struck by 2 major earthquakes at 4:36 am on 4 September 2010, magnitude 7.1 and at 12:51 pm on 22 February 2011, magnitude 6.3. Both events caused widespread destruction. Christchurch Hospital was the region's only acute care hospital. It remained functional following both earthquakes. We were able to examine the effects of the 2 earthquakes on acute cardiac presentations.
  
  
  METHODS
  Patients admitted under Cardiology in Christchurch Hospital 3 week prior to and 5 weeks following both earthquakes were analysed, with corresponding control periods in September 2009 and February 2010. Patients were categorised based on diagnosis: ST elevation myocardial infarction, Non ST elevation myocardial infarction, stress cardiomyopathy, unstable angina, stable angina, non cardiac chest pain, arrhythmia and others.
  
  
  RESULTS
  There was a significant increase in overall admissions (p<0.003), ST elevation myocardial infarction (p<0.016), and non cardiac chest pain (p<0.022) in the first 2 weeks following the early morning September earthquake. This pattern was not seen after the early afternoon February earthquake. Instead, there was a very large number of stress cardiomyopathy admissions with 21 cases (95% CI 2.6-6.4) in 4 days. There had been 6 stress cardiomyopathy cases after the first earthquake (95% CI 0.44-2.62). Statistical analysis showed this to be a significant difference between the earthquakes (p<0.05).
  
  
  CONCLUSIONS
  The early morning September earthquake triggered a large increase in ST elevation myocardial infarction and a few stress cardiomyopathy cases. The early afternoon February earthquake caused significantly more stress cardiomyopathy. Two major earthquakes occurring at different times of day differed in their effect on acute cardiac events.
authors.affiliation: Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand. christinachannz@gmail.com
authors.forename: Christina
authors.initials: C
authors.lastname: Chan
authors.forename: John
authors.initials: J
authors.lastname: Elliott
authors.forename: Richard
authors.initials: R
authors.lastname: Troughton
authors.forename: Christopher
authors.initials: C
authors.lastname: Frampton
authors.forename: David
authors.initials: D
authors.lastname: Smyth
authors.forename: Ian
authors.initials: I
authors.lastname: Crozier
authors.forename: Paul
authors.initials: P
authors.lastname: Bridgman
mesh_terms: D000208:Acute Disease; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000503:physiopathology; D000789:Angina, Unstable / Q000175:diagnosis / Q000503:physiopathology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology; D002637:Chest Pain / Q000175:diagnosis / Q000503:physiopathology; D004190:Disasters; D055866:Earthquakes; D004562:Electrocardiography; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D009520:New Zealand; D010343:Patient Admission / Q000706:statistics & numerical data; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors