Hemostatic activation and cardiac events after the 1995 Hanshin-Awaji earthquake.

Earthquake-induced stress seems to induce rheological deterioration associated with high blood pressure, an increase of blood viscosity due to hemoconcentration and an increase of the fibrinogen level. These changes lead to prolonged endothelial cell injury and accelerate fibrin turnover as the result of a high D-dimer level. An increase of these acute changes caused by mental and physical stress after an earthquake might trigger obstructive thrombus in coronary arteries in the elderly.