From The Straits Times    |

How stress can cause a heart attack or sudden death

Illustration: Jesadaphorn Chaiinkeaw,

With momentous life changes, it is often our response to them that causes stress to our bodies. 

Dr Mak Koon Hou, a cardiologist and board member of the Singapore Heart Foundation, sheds some light on the link between stress and heart health. 

Q. How is stress related to the heart? 
A. Stress is a state induced when we face a significant challenge in our usual routine. Our body is conditioned to react to such challenges, whether they are positive or negative, by a complex neurological and hormonal system.

This is so whether we are confronted by a tiger or in the presence of a very attractive person, said Dr Mak. To enable someone to be alert and to act rapidly, the body raises the heart rate, breathing rate and blood pressure. 


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Food stores such as glucose are released into the blood stream so that the body has the resources to react to the situation, the so-called fight-and-flight response. 

Rapid and long-term responses to the source of the stress may have detrimental effects on the body. Chronic stress is usually not good for health. 


Q. What are stress-related cardiac issues? 
A. In some cases, though uncommon, stress can lead to a heart attack or sudden death. Dr Mak heard about a woman who had a heart attack after quarrelling with another woman over a minor accident in a carpark. 

The incident caused a small dent in one car, but voices were raised and tempers flared. One of the women then complained of severe chest pain. A doctor later found that she had experienced a heart attack, he said. 

“It was not caused by a blocked artery. She had a condition known as “broken heart syndrome”. Fortunately, her outcome was good.”

Broken heart syndrome is a temporary heart condition that is usually triggered by the sudden release of stress hormones. 


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Dr Mak said that in some of these cases, the heart rhythm may become totally erratic and the person may die suddenly.

This is known as ventricular fibrillation, when the heart’s lower chambers quiver and cannot pump blood to the body. In cases of long-term stress, like work stress, the blood pressure may be raised. 

Long-term stress is associated with other chronic illnesses, as well as eating and sleep disorders. These conditions may eventually affect the heart. 


Q. Can managing stress prevent heart problems? 
A. Unlike a blood sugar or blood pressure reading, stress cannot be easily quantified. It is measured in other ways, for example, using questionnaires. It is thus not easy to determine how managing stress can reduce or prevent heart problems.

“Studies, particularly those followed up for long periods, are difficult to conduct,”said Dr Mak. “But empirically, we believe that by minimising the adverse consequences of stress, the occurrence of heart problems may be lowered.”

Learn to relax 

  • Learn breathing techniques or join meditation programmes to help lower your blood pressure and heart rate. 
  • This will help to divert your attention from stress-inducing circumstances. Stress is a person’s response to a threatening situation. It is the connection between your heart and mind. By recognising how your body reacts to various circumstances, you may be able to learn when and how to relax. 
  • Take part in activities that you enjoy doing.
  • Have a hobby as this helps to relieve stress. Seek professional help if needed.

This story was originally published in The Straits Times.