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Can Stress Cause a Heart Attack?

Just 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"? 

What stress does to your body

When faced with a stressful situation (known as acute stress) — 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. 

Stress and heart health

"In a person with a healthy cardiovascular system, this surge shouldn't be a problem," says Rami Doukky, MD, a cardiologist at Rush.

However, if there is underlying heart disease, the sudden increase in blood pressure and heart rate could contribute to events leading to a heart attack. For example, in people with atherosclerosis, or cholesterol buildup in their arteries, the increase could cause plaque to rupture and block blood flow, which could result in a heart attack.

The surge can also expose people with existing heart disease to the risk of an arrhythmia, which is an irregular heartbeat. 

"There is no solid evidence that stress can directly cause a heart attack," says Doukky. "However, chronic stress — the kind of stress that's due to ongoing situations like a bad relationship or difficult job — can lead to risk factors that affect heart health." 

Chronic stress has been linked to overeating (which can result in obesity), poor sleep habits and tobacco and alcohol use — practices that could translate into high blood pressure, a major risk factor for cardiovascular disease as well as diabetes.

For older adults, who are already at a higher risk for heart disease because of progressive atherosclerosis associated with aging, stress may increase their chances of developing heart disease, Doukky says. 

Decompress

Since stress is often unavoidable, it's best to offset it.

"Exercise is a great way to relieve stress because it can decrease the production of stress hormones and increase production of endorphins, neurotransmitters that can elevate mood," Doukky says. "Swimming, biking or simply walking around the neighborhood can make a difference."

Transcendental meditation — mental concentration and physical relaxation through the use of a mantra, a repeated phrase or syllable — may also help; it's been shown to reduce blood pressure.

And if stress-related weight gain and alcohol or tobacco use threaten wellness, Doukky says, a psychologist or psychiatrist may be needed. 

And so the next time a loved one warns you of the dangers of stress, recognize that there is a basis for their concerns. Although an immediate heart attack is unlikely, the ways you handle your stress can either put your heart at risk or keep stress at bay. 

At risk for a heart attack?

If you think you are at risk for a heart attack, have chronic or recurrent chest pain, or have chest discomfort brought on by exertion and relieved by rest, contact your primary care physician or a heart specialist at Rush. To make an appointment, call (888) 352-RUSH (7874).