Acute Stress and Heart Attacks
Acute stress is a sudden, intense reaction to pressure or a threat. It comes on quickly and activates the body’s fight-or-flight response to address the issue or to run from it.
You may feel it during emotionally overwhelming moments, such as receiving devastating news, experiencing a traumatic event, or losing a loved one. It can also occur during situations that make you extremely nervous or excited.
When acute stress hits, the body releases stress hormones such as adrenaline and cortisol, says Michael Blaha, MD, a cardiologist at Johns Hopkins Medicine in Baltimore. Together, they raise your heart rate, cause blood-pressure increases, and constrict blood vessels.
These factors — especially when you already have a buildup of plaque in your arteries — can lead to a heart attack in certain situations, he says.
“Studies have shown increased rates of heart attacks after emotionally intense events such as major sporting matches and natural disasters, even when there is no direct physical injury involved,” Dr. Blaha says.
When stress hits, you may first notice an increase in your heart rate, he says. Although a faster heart rate alone isn’t necessarily dangerous, it reflects how hard you are pushing your cardiovascular system at that moment.
As stress hormones cause your heart to beat faster, they also increase blood pressure and narrow blood vessels, called vasoconstriction.
“Blood vessels constrict to help maintain blood pressure during danger, and that’s a normal and important function,” Blaha says.
But during intense stress, coronary arteries can constrict enough to reduce or restrict blood flow to the heart, he says. Clots also may form as your body produces more platelets, especially if you have underlying heart issues.
For people who already have plaque buildup in their arteries, acute stress can push an already vulnerable system toward a heart attack.
“If someone has a lot of plaque in their arteries already, stress can raise blood pressure, increase clotting, and worsen blood flow all at once,” Blaha says.
In less common cases, vasoconstriction or coronary artery spasms alone may limit enough blood flow to the heart to damage it.
“I’ve seen people who don’t have significant plaque or traditional risk factors develop a small heart attack during extreme stress,” Blaha says.
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