title: Heart attacks triggered by huge mud slides in mountain regions and severe flooding in inhabited areas.
abstract: BACKGROUND
  On July 12, 2012, heavy rains struck southwest Japan, particularly in the Mount Aso area. Huge mud slides in the mountains destroyed houses, and heavy rains caused severe flooding in the inhabited areas. We investigated the incidence of cardiovascular events after the disaster.
  
  
  METHODS
  We investigated patients who were admitted to the emergency department (ED) from July 12 to August 31 in 2012. We reviewed all patients with cardiovascular events, including acute myocardial infarction (AMI), angina attack, worsening of congestive heart failure (CHF), cardiopulmonary arrest (CPA), arrhythmias, tako-tsubo cardiomyopathy (TC), and symptomatic venous thromboembolism (VTE).
  
  
  RESULTS
  The total number of cardiovascular events was 28 (14 supraventricular arrhythmias, 3 angina attacks, 1 AMI, 1 VTE, 4 CHF, 1 TC and 4 CPA). There was a significant increase in cardiovascular events during the follow-up period in 2012 in comparison with the average number of these events over the same time period during the prior 2 years (16.8 vs. 5.1/month, p<0.01). There was a sharp increase in cardiovascular events in the first week after the disaster. A second peak was observed 7 weeks after the disaster. Two patients with angina attack were previously diagnosed as having vasospastic angina. The incidence rate of AMI did not increase.
  
  
  CONCLUSIONS
  An increase in cardiovascular events was observed after severe rainfalls and mud slides. Prevention of disaster-induced cardiovascular events should be a priority regardless of the magnitude of the disaster.
authors.affiliation: National Health Insurance Aso Central Hospital, Aso City, Japan; Department of Cerebrovascular and Acute Coronary Syndrome, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Japan. Electronic address: ynagayos@kumamoto-u.ac.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagayoshi
authors.affiliation: National Health Insurance Aso Central Hospital, Aso City, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yumoto
authors.affiliation: National Health Insurance Aso Central Hospital, Aso City, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sakaguchi
authors.affiliation: National Health Insurance Aso Central Hospital, Aso City, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Shudo
authors.affiliation: National Health Insurance Aso Central Hospital, Aso City, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Takino
authors.affiliation: National Health Insurance Aso Central Hospital, Aso City, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hashiyama
authors.affiliation: Department of Cerebrovascular and Acute Coronary Syndrome, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kai
authors.affiliation: Department of Community Medicine, Kumamoto University Hospital, Kumamoto City, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kuroda
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology / Q000209:etiology; D004190:Disasters / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D055868:Floods / Q000706:statistics & numerical data*; D006331:Heart Diseases / Q000453:epidemiology* / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D055876:Landslides / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors
keywords: Flooding; Mud slides; Supraventricular arrhythmias