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Investigations in triggering of acute cardiac disorders have elucidated that physical and sexual activity markedly and briefly increase the risk of such events. These common activities activate the sympathetic nervous system and may be considered typical ‘sympathetic’ triggers.1 Heavy physical activity precedes around 6% while sexual activity precedes 1% of all acute myocardial infarctions.2 Considering the strength and exposure, it seems that air pollution is the most public health relevant trigger of myocardial infarction, immediately followed by heavy exertion, whereas sexual activity has lower relevance. Nawrot and colleagues estimate that 6.2% of all infarction cases could be avoided if the …
Competing interests None.