On the way to a dinner appointment last week, a patient—whom we’ve been treating for a heart ailment and who has been free of angina (chest pains due to lack of oxygen in the heart) for quite some time—was caught in a horrendous traffic jam along Edsa.

He started experiencing chest tightness, and instructed his driver to turn back and bring him to the hospital emergency room.

We ran the usual tests and observed him overnight. Fortunately for him, the angina didn’t progress to a heart attack, and he was discharged with some adjustments in medication.

We advised him to upload Mozart music to his mobile phone or tablet, and to just listen to it when stuck in traffic, instead of fretting over the apparently unsolvable traffic problem in Metro Manila.

Some studies have shown that those who listened to Mozart’s classics like “Eine Kleine Nachtmusik” experienced more psychological relaxation and less stress-related symptoms than either those who listened to so-called New Age music or read popular recreational magazines.

Incidentally, one thing that likely triggered his chest pains was his full bladder, so we also advised him to have a small plastic urinal in the car, in the event of another “traffic emergency.”

Susceptible persons

This case reminded us of a 2004 published study by professor Annette Peters and her colleagues at Augsburg Health Research Center in southern Germany. They concluded in the study that transient exposure to traffic may increase the risk of myocardial infarction (heart attack) in susceptible persons.

Peters’ group looked at the data from 691 survivors of heart attack from 1999 to 2001 in Germany. We figure our Manila traffic jams now are a lot worse than when this study was conducted.

In the German study, one out of 12 heart attacks was linked to exposure to traffic, and the traffic jam increased the risk of heart attack regardless of what form of transport the victims were taking.

There was an almost threefold risk for people stuck in their cars or private vehicles, a more than threefold risk for those in buses and other forms of public transport, and an almost fourfold risk for the cyclists.

The increased risk for cyclists is likely attributable to the increased volume of pollutants in the air in a traffic jam.

So, figuratively and literally, all roads in a traffic jam may lead to a heart attack.

Before this German study, previous studies already showed an association between exposure to vehicular traffic in urban areas and the exacerbation of cardiovascular disease, so this study validated all these previous observations.

The 691 subjects in the study were survivors of at least 24 hours after the attack, were able to complete the researchers’ standardized interview, and provided information on factors that may have triggered the heart attack.

The researchers were able to establish a clear association between exposure to traffic and the onset of the heart attack within one hour afterward.

There also appeared to be a correlation between the length of time the subjects spent in cars, in public transportation, or on motorcycles or bicycles and the increased risk of heart attack.

They discounted the role of other confounding triggering factors, such as the level of exertion those on bicycles had. Definitely, though, the increased severity of air pollution is a risk factor associated with traffic jams, which can play a role for pedestrians and those riding on bicycles or motorcycles.

The same problem is true for our traffic enforcers.

Unemployed

An interesting finding was that the association between exposure to traffic and the onset of a heart attack was stronger in the subgroup of subjects who were unemployed than in the subgroup of those who were employed. This means that the observed increased risk was not due to commuting regularly to work.

So, the traffic jam was not necessarily a repeatedly experienced triggering factor. Even a one-time exposure to a traffic jam could increase the risk of a heart attack.

Definitely, the stress factor has a lot to do with the increased risk. Probably, the level of stress of the unemployed was higher (because they didn’t have a job).

Anyway, one really has to avoid the double-whammy of stress when stuck in traffic. This is a perfect instance when worrying, cursing the traffic enforcers, the government, the car manufacturers, the rich people who buy one car for every child, and whoever or whatever may be related to the increase in the traffic won’t do any good in alleviating the problem.

The shooting adrenaline levels caused by one’s inappropriate agitation may increase the blood pressure, cause the heart to beat faster and pump harder, and induce an irregular heartbeat that may even cause sudden death in vulnerable individuals. These poor individuals don’t even reach the hospital alive, and many heart attack patients suffer this fate.

So, rather than cursing the universe when stuck in traffic, whether you’re driving or commuting, just play whatever soothing music you have and visualize the utopian country we hope to become when we can travel from Makati to Quezon City in a breeze along Edsa, no matter what time of day.

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