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London Heart

Emotional Stress and Heart Attack: Awareness and Prevention

Most people are aware of the link between blocked coronary arteries and an increased risk of heart attack. The arteries become blocked by blood clots and this lack of blood flow causes sections of heart muscle to die, triggering a heart attack.

Can stress cause a heart attack?

Far fewer people are aware of the link between emotional stress and heart attacks. These types of heart attacks – called takosubo cardiomyopathy (or stress cardiomyopathy) – are less common than those caused by blocked arteries but can be just as deadly.

In a 2015 study, published in The New England Journal of Medicine, clinicians from Europe and the US studied 1,750 patients with emotional stress heart attack. They concluded that the most common triggers were physical health conditions, such as infections or lung problems and sudden emotional shock or stress.

People who experience a takosubo heart attack are twice as likely to have a psychiatric or neurological disorder than those who have the more common form of heart attack.

And, while clinicians initially believed that stress cardiomyopathy was less harmful than other forms of heart attack, this has now been disproved and researchers concluded that rates of death were comparable.

The British Heart Foundation warns that while stress alone won’t cause heart and circulatory diseases, it is linked to unhealthy habits, such as smoking, eating junk food or drinking, that can increase your risk. Such habits are linked to high blood pressure, high cholesterol and Type 2 Diabetes.

Chest pain: anxiety or heart attack?

Sometimes it can be hard to tell the difference between a heart attack and a panic attack, as the symptoms can be similar.

For example, a panic attack can cause a sharp pain in the chest, shortness of breath, racing heart, sweating and shaking. Heart attack symptoms include chest pain, shortness of breath, sweating, nausea and vomiting.

However, there are some important differences:

  • During a heart attack, the pain in your chest often feels like pressure or a squeezing sensation. It may start in the centre of the chest but then radiate out to your jaw, arm or shoulder blades. The chest pain caused by a panic attack is sharp or stabbing and remains in the middle of the chest.
  • Panic attacks are normally over within a matter of minutes, although they can go on for longer. By contrast, the symptoms of a heart attack tend to last longer and may worsen over time.

  • Sometimes a heart attack can be triggered by some kind of physical exertion, whereas a panic attack rarely begins this way.

Learn more about chest pain by watching our animated video:

How to reduce stress

If left unaddressed, stress and anxiety can play a role in the development of coronary artery disease so it is important to reduce the impact of stress in your life.

It is helpful in the first instance to be able to recognise the signs of stress. These include:

  • Emotional symptoms such as feeling upset, afraid, angry, hopeless or disinterested in life.

  • Physical symptoms which might include heart palpitations, headaches, dizziness or sickness, tiredness and problems sleeping, poor appetite or comfort eating.

  • Compulsive behaviours such as nail biting, irritation or skin picking.

Ideally, try to develop healthy habits to help you deal effectively with stress and anxiety before it can become a problem.

Avoid resorting to unhealthy coping mechanisms such as smoking and drinking. Instead, introduce some regular gentle exercise such as a walk in the fresh air. This helps to release endorphins that trigger positive feelings in your body.

Techniques for helping yourself to handle stress include meditation, yoga and mindfulness. Talking to a trusted friend or counsellor can also help.

When to see a doctor

It is important not to just press on if you are struggling with symptoms of stress or anxiety because, left unaddressed they can have long-term health impacts.

Talk to a GP if you are experiencing ongoing or worsening symptoms. If you experience a mental health crisis there are organisations that can provide support, including the Samaritans (116 123) and mental health charity, Mind.

If you are concerned about your heart health you may wish to have a specialist cardiac screening. This will check your overall heart health and spot early warning signs of heart disease.

Screening involves a comprehensive range of tests performed in the clinic by expert cardiologists. It takes around 2-4 hours and you will receive a report of your results and any recommended treatment or follow up tests.

Book an appointment

To book a private heart health check visit our appointment page.