You know that stress can trigger a heart attack, but do you know HOW this process occurs, what actually goes on inside your body leading up to the cardiac event?
If a person’s health is in enough of a compromised state, a sudden and unexpected scare or intense flood of anxiety could cause a heart attack. So can ongoing anxiety over time.
But as just mentioned, that person’s body must already be in poor health.
Otherwise, younger and fitter people would be dropping like flies from heart attacks experienced while being in a vehicular crash in which the moments leading up to the collision could scare the daylights out of people in the vehicle.
And think of all the younger fitter people who suffer ongoing anxiety for months on end; they are not dropping from cardiac events.
That said, there really are people who suffer a heart attack from an acute moment of stress or fright.
The heart attack may happen right at that moment, later on that day or even the next day.
There are two kinds of stress or anxiety: chronic and acute.
Chronic is like job stress, ongoing. Acute is being in an elevator that suddenly stops and a fire breaks out.
“Both forms of stress, whether chronic or acute, lead to release of hormones, adrenaline and cortisol, which cause physiologic changes,” points out John M. Kennedy, MD, medical director of preventative cardiology and wellness at Marina del Rey Hospital.
Physiologic Changes of Stress that Can Lead to Heart Attack
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• Increased body-wide inflammation
• Elevated heart rate and blood pressure
• Thick sticky blood
The changes in points two and three help the person, who’s undergoing the siege of acute stress, fight off or escape from that source of stress. That sounds like a benefit.
But Dr. Kennedy says that these changes, including the first bullet point, “create the perfect storm for a cardiac event by damaging the delicate inner lining of blood vessels.”
It doesn’t end there; it gets worse.
“Additionally, acute and chronic stress can trigger an arrhythmia (an abnormal heart rhythm) known as atrial fibrillation, which causes the upper chambers of the heart to quiver, causing the blood to become stagnant and prone to forming a clot,” notes Dr. Kennedy, author of the book, “THE 15-MINUTE HEART CURE: The Natural Way to Release Stress And Heal Your Heart In Just Minutes A Day.”
This clot has the potential to cause an obstruction in the heart’s blood flow: a heart attack.
If it dislodges and gets into the bloodstream, “it can travel to the brain and obstruct blood flow, causing a stroke,” says Dr. Kennedy.
Hold on—there’s more. Remember that third bullet point, thick sticky blood? That’s a problem.
Thick sticky blood is more likely to clot. This can happen in the heart, and if the clot is big enough…you have a cardiac event.
Thickened blood is important in the so-called fight or flight situation.
These physiologic changes helped our ancient ancestors survive the brutal elements during the Stone Age.
Imagine the potential for acute stress, e.g., a wild boar at the next turn.
Ancient man in a fight with an animal gets gashed and starts bleeding.
The acute fear has thickened his blood, making it less likely he will bleed to death, because the blood clots faster.
However, thin blood, much less likely to clot (which is why people at risk for heart attacks and strokes are often put on prescription blood thinners), is also more likely to result in fatal hemorrhaging.
The body knows to thicken up the blood when anxiety and fright abound, to protect against fatal hemorrhaging in a fight against or escape from danger—when a portion of the body might get ripped open.
The intense physical exertion that ensues during the fight or escape releases hormones (such as testosterone) that soon nullify the effect of the stress hormones, so that once our primitive ancestors got to safety, they were no longer at risk for a heart attack.
But this nullification never happens if the source of chronic stress is being trapped in an office cubicle all day in a hostile work environment.
You’re sitting there, seething, for hours on end, day in and day out, with no intense physical exertion to oppose the stress hormones. These hormones build up and over time, become harmful.
The acute sudden stress response occurs just the same whether the person is a primitive wearing animal skins escaping from a hungry lion, or a modern-day person who has a gun pointed to him by a home intruder.
Mildred Pollock, 89, suffered a fatal heart attack a week after two men invaded her home. They had not injured her. Coincidence?
And leehighvalleylive.com reports the case of a woman, 76, who suffered a mild heart attack the night of her home invasion and died several weeks later.
The forensic examiner noted that she had a pre-existing cardiac condition, but blamed the acute stress of the invasion on the heart attack.
Double board certified in cardiovascular disease and also internal medicine, 
