Monday, March 20, 2023

Why Does Stress Cause Heart Attacks

Stress Versus Cholesterol For Coronary Heart Disease

EP38: Does Stress Cause Heart Attacks?

It has long been recognized that severe or sudden emotional stress could result in a heart attack or sudden death. Walter Cannon at Harvard first delineated the mechanisms responsible for this in the early part of the last century. Cannons studies demonstrated that responses to the stress of acute fear resulted in a marked increase in sympathetic nervous system activity and an outpouring of sympathin that prepared the animal for lifesaving fight or flight. His later studies of the mechanism of bone pointing or voodoo death also implicated excess secretion of hormones from the adrenal medulla into the blood stream as the most likely cause of fatal arrhythmia. Hans Selyes formulation of the stress concept in the late 1940s provided further insight into the role of pituitary and adrenal cortical hormones in mediating damaging cardiovascular responses to stress.

Broken Heart Syndrome Another Avenue To Consider

Though this name implies that a romantic breakup can harm the heart, thats not what this term refers to.

Sudden stress can cause a heart attack due to Takotsubo syndrome or broken heart syndrome, says Nieca Goldberg, MD, medical director of NYU Womens Heart Program and radio show host of Beyond the Heart on Doctor Radio SiriusXM.

Dr. Goldberg explains, It this form of heart attack the patient has abnormal heart function and normal arteries. Over time the heart function improves.

Elderly people may have underlying heart disease, and this may be due to plaque rupture, but another cause may be Takotsubo syndrome.

Stress-induced cardiomyopathy another name for broken heart syndrome is when the left ventricle in the heart weakens.

This has nothing to do with clogged arteries or plaque fragments obstructing blood flow.

That left ventricle is the hearts main pumping mechanism. Severe emotional stress such as that would be experienced by a home invasion, home fire, a car accident or learning tragic news can literally weaken this pumping chamber.

Your Best Defenses Against Stress

Exercise and eating well are some of the best ways to manage stress.

Exercise improves your mood, and studies have shown that a person who regularly exercises is also less likely to excessively drink or smoke. Physical activity and healthy eating also help with the prevention of obesity-related diseases.

When practiced regularly, these healthy habits can delay the onset of other health conditions, even if a person may be genetically predisposed to them including high cholesterol and hypertension.

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Can Anxiety Cause A Heart Attack

Many studies have linked heart disease and depression, but heart problems may also go hand in hand with anxiety.

Several studies have shown that about a quarter of people with cardiovascular disease have some kind of anxiety problem and, in some cases, the anxiety seems to make the heart condition worse.

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How To Reduce Anxiety And Chest Pain

Panic Attacks: Common Symptoms and How to Cope

The best way to manage chest pain is with prevention and by reducing your overall anxiety symptoms. The less you experience anxiety, the less risk you’ll have for chest pain.

If you’re currently experiencing anxiety and chest pain, the best things to do are the following:

  • Control Your Breathing Recall that this type of chest pain is often caused by hyperventilation, and even if you’re not hyperventilating, getting your breathing under control is a great way to calm the nerves. Take slow, controlled breaths using deep breathing techniques that take at least 15 seconds and you’ll quickly see a difference. Try to breathe in through your nose and out through your mouth, breathing deep from your diaphragm rather than shallow from your chest.
  • Control Your Thoughts One of the reasons I recommend going to a doctor first is because understanding that your chest pain is anxiety related reduces the severity of the experience. If you know that your heart is in good health, don’t let your thoughts spiral out of control because that may make the chest pain worse.
  • Control Your Environment Chest pain caused by thoughts or anxiety is often made worse when you sit and focus on the experience. See if you can give yourself a healthy coping distraction, and much of the chest pain will fade away. Some suggestions for this include changing your location , listen to relaxing or happy music, talk on the phone with a trusted friend, or use grounding techniques to focus on the present.

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How To Manage Stress And Reduce Your Heart Attack Risk

Reducing and managing stress through mindfulness, exercise, and hobbies is an important part of overall health, and it may improve cardiac health.

However, making lifestyle changes to reduce stress is extremely difficult for people. Because of that, Gilstrap recommends her patients take a realistic look at the stressors in their lives and adjust what they can, without worrying too much about whats out of their control.

Life is complicated and people have demands from a variety of places, Gilstrap says. Its about fixing the ones that can be fixed, building on that success, and empowering the patient to make even more positive change in that direction.

What Stress Does To Your Body

When faced with a stressful situation such as rush-hour traffic or babysitting an ornery grandchild our bodies release hormones, including cortisol and adrenaline, which help us react to the situation.

These hormones increase heart rate and blood pressure, supplying the body with a burst of energy and strength. This creates a “fight or flight” reaction that, when you’re in actual danger, helps you defend yourself or flee.

When the “danger” or stressful scenario passes, the body’s relaxation response kicks in and hormone levels return to normal.

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Recognize Stress Sneaking In

Going through a divorce can be quite stressful, but until recently researchers didnt know how long the health effects of that stress might last.

In a recent study that followed participants over 18 years, women going through two or more divorces had a rise in heart attack risk that was similar to that of a smoker or a person with diabetes. The study found a higher heart attack risk in men whod had multiple divorces too. Though men did see a health benefit from remarriage, women did not. Even decades after a divorce, relationship stress can leave a powerful imprint on your health.

Work-related stress can also harm your heart. Research has found that people who are more worried about losing their job are nearly 20 percent more likely to have heart disease. But people who are happy in their jobs may be chronically stressed as well because of the competitiveness of their jobs or because theyre trying to balance their work and home life, Blaha says.

Surprisingly, even stress related to enjoyable events may raise your risk of a heart emergency. During a recent World Cup soccer event, heart attacks more than doubled in one German city during days when the nations team was playing.

The Effect Of Anxiety On The Heart

Stress and Heart Attacks | Causes of Heart Disease

When someone is anxious, their body reacts in ways that can put an extra strain on their heart. The physical symptoms of anxiety can be especially damaging among individuals with existing cardiac disease.

Anxiety may have an association with the following heart disorders and cardiac risk factors:

  • Rapid heart rate In serious cases, can interfere with normal heart function and increase the risk of sudden cardiac arrest.
  • Increased blood pressure If chronic, can lead to coronary disease, weakening of the heart muscle, and heart failure.
  • May result in higher incidence of death after an acute heart attack.

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Anxiety Disorders In Patients With Cardiovascular Disease

While much of the literature to date has focused on the associations between anxiety as a symptom and cardiovascular health, it may be more important to examine the links between anxiety disorders and heart health. By definition, anxiety in the setting of anxiety disorders is chronic and persistent, and therefore it may have greater physiologic consequences than transient anxiety. Furthermore, effective treatments are available for anxiety disorders.

Can Panic Attacks Cause Heart Attacks

Finally, another issue that worries people is whether an anxiety attack can cause a heart attack.

The short answer is no, not on their own. But the long answer is that long term stress can damage the body, including the heart, and may contribute to health issues years down the road. Also, those that do have a heart problem but also suffer from panic attacks may be at greater risk for a heart attack, although the risk isn’t enormous.

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Sudden Stress Can Cause Broken Heart Syndrome Which Feels Like A Heart Attack

One of the most dramatic ways stress can affect your heart is by causing takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or “broken heart syndrome.”

This feels just like a heart attack, with symptoms including chest pain and shortness of breath, but it is a different condition altogether, says Lauren Gilstrap, MD, a cardiologist at Dartmouth Hitchcock Medical Center.

Those symptoms come on suddenly, triggered by a stressful emotional event, such as the sudden death of a loved one. “Its presentation isn’t subtle,” Gilstrap says. “People think they’re having a heart attack.”

However, that’s not the case. A heart attack occurs when an artery to the heart is blocked. Takotsubo cardiomyopathy has no underlying blockages. Its exact causes aren’t known, but are thought to be tied to a sudden hormonal surge from the body’s fight or flight response.

“Takotsubo cardiomyopathy is a fundamentally different phenomenon than a heart attack,” Gilstrap says. “The arteries are completely fine and the blood supply is completely normal, but all of a sudden, the heart doesn’t squeeze.”

Takotsubo cardiomyopathy is most common in women aged 58 to 75, who make up more than 90% of cases. Doctors aren’t entirely sure why, but one study found that women experience higher rates of emotional stress. About 5% of women who think they’re having a heart attack are actually experiencing stress-induced cardiomyopathy.

Chronic Stress Can Cause Heart Trouble Too

Stress with Heart Attack

Initially, takotsubo cardiomyopathy was identified in patients who experienced sudden, extreme stress. But doctors now recognize that it can also occur in people who have more prolonged stressors such as a major project at work or relationship stress at home, Gilstrap says.

Chronic stress is also linked to heart disease in a number of ways. Experiencing chronic stress, including that from racial biases, poverty, or relationship troubles, increases your risk of hypertension, according to a 2013 study in Current Hypertension Reports. Hypertension is a major risk factor for heart disease.

Stress can also contribute to unhealthy habits like smoking, drinking or overeating, all of which are tied to adverse effects on heart health, according to the American Heart Association.

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Guidelines For Healthy Eating To Fight Stress

  • Eat a wide variety of healthy foods.
  • Eat in moderation — control the portions of the foods you eat.
  • Reach a healthy weight and maintain it.
  • Eat at least 5 to 9 servings of fruits and vegetables per day.
  • Eat food that is high in dietary fiber such as whole grain cereals, legumes, and vegetables.
  • Minimize your daily fat intake. Choose foods low in saturated fat and cholesterol.
  • Limit your consumption of sugar and salt.
  • Limit the amount of alcohol that you drink.
  • Make small changes in your diet over time.
  • Combine healthy eating habits with a regular exercise program.

Anxiety And Heart Disease

The association between anxiety and heart disease has not been as fully studied as the relationship between depression and heart disease.

However, Una D McCann, M.D., director of the Anxiety Disorders Program at Johns Hopkins Bayview Medical Center, believes the connection is strong.

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Can Stress Trigger Heart Attacks

A major new study has lent support to the idea chronic stress can increase your risk of heart attack.

The idea ongoing stress can increase our risk of heart attack is so popular, it’s widely regarded as fact by many of us.

But plenty of medical researchers have not been convinced, arguing that evidence has been lacking. Now a high quality study has thrown new light on the topic. It suggests if you feel stress is affecting your healthy badly, you’re probably right at least in terms of your heart attack risk.

The findings suggest ongoing stress could be as potent a risk factor for heart attacks as high blood pressure or high cholesterol, says Murray Esler, Professor of Medicine at Monash University and a clinical cardiologist at Baker IDI Heart and Diabetes Institute.

The new study followed more than 7000 male and female public servants in Britain for 18 years. It found those who felt the stress or pressure they’d experienced in their life had affected their health “extremely” or “a lot” had double the risk of a heart attack compared with those who reported no effect of stress on their health.

“This is a very significant finding from a significant study,” says the Heart Foundation’s clinical services director Dr Robert Grenfell.

How Does Sudden Stress Lead To Heart Muscle Weakness

Can Stress Cause A Heart Attack?

When you experience a stressful event, your body produces hormones and proteins such as adrenaline and noradrenaline that are meant to help cope with the stress.

The heart muscle can be overwhelmed by a massive amount of adrenaline that is suddenly produced in response to stress. Excess adrenaline can cause narrowing of the small arteries that supply the heart with blood, causing a temporary decrease in blood flow to the heart.

Alternatively, the adrenaline may bind to the heart cells directly, causing large amounts of calcium to enter the cells. This large intake of calcium can prevent the heart cells from beating properly. It appears that adrenalines effects on the heart during broken heart syndrome are temporary and completely reversible the heart typically recovers fully within days or weeks.

What should I do if I feel the symptoms of broken heart syndrome?

If you experience heart-attack-like symptoms, call 911 immediately. If your symptoms are mild, please contact your doctor immediately.

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If I Am Diagnosed With Broken Heart Syndrome What Treatment Should I Receive

It is important to follow up with a cardiologist who is familiar with this syndrome and who can tell you when your heart muscle has fully recovered. Early on, the cardiologist may want to treat you with standard medications for heart muscle weakness, but this will depend on several factors including your heart rate and blood pressure.

Your doctor may suggest an exercise program including cardiac rehabilitation. Avoiding stressful situations if possible is always recommended, and interventions to reduce stress such as biofeedback, meditation, yoga, physical rehabilitation and exercise can be very helpful to some patients with this syndrome.

Can Stress Cause A Heart Attack

An expert explains how much can stress affect heart health

Stress can trigger insomnia, exacerbate digestive problems and cause muscle tension that leads to body aches.

But can stress cause a heart attack? Or is it just a dire, unsubstantiated warning offered by concerned family and friends along the lines of “You’ll catch pneumonia if you go outside with your hair wet”?

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Why Do People With Heart Conditions Feel Anxious

Many people worry about the future when theyve just been diagnosed with a heart condition. Its common to feel anxious after a life changing heart attack or surgery or when having symptoms such as chest pain. Anxiety about whether a device like a pacemaker or ICD will not work properly is also very common.

Feeling anxious, worried or fearful is a natural response to life changing experiences. For most people the fear and anxiety eases off as they come to terms with their condition and learn how to manage it.

But its important to recognise when these feelings carry on for longer than usual and start affecting your health, relationships and quality of life.

Panic Attack Or Heart Attack

How heart attack happens?

The symptoms of a panic attack can overlap the symptoms of a heart attack, clinically termed myocardial infarction , making it difficult for a person to know which one may be occurring.6 People often go to the emergency room with chest pain believing they have a heart issue, but research shows that roughly 60% to 90% of ER patients with chest pain do not have a cardiac cause of the pain.7

How does a panic attack feel different from a heart attack?

Unfortunately, says Una McCann, MD, professor of psychiatry and director of the Anxiety Disorders Program at Johns Hopkins School of Medicine, They can feel identical. People often are short of breath, feel dizzy, and can feel crushing chest pain. Somebody who is perfectly healthy, with great lungs, undergoing a panic attack can feel really, really short of breath. And then, of course, those symptoms feed on the panic so it builds exponentially to this enormous crescendo.

Dr. McCann explains that because of the many different ways that people experience symptoms of heart attacks and panic attacks, theres no way to know the cause of those symptoms on your own.

There are a variety of symptoms that people who are having myocardial infarctions experience or dont experience, so certainly if someone came in with a panic attack to an emergency room, they would undergo a full workup for an MI, no question, she says.

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