Heart attacks can also be caused by emotional stress

Mentally stressful situations increase the risk of heart attacks, even in healthy people. A conscious handling of (emotional) stress is important for the prevention of cardiovascular diseases. (Image: BillionPhotos.com/fotolia.com)

Heart attack: Mentally stressful situations as a trigger are underestimated

According to health experts, mentally stressful situations increase the risk of heart attacks, even in healthy people. A conscious handling of (emotional) stress is important for the prevention of cardiovascular diseases.

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Increased risk of heart attack due to grief or bullying

Most people should be aware that the risk of a heart attack and other heart diseases is increased by factors such as being overweight or obese, high blood pressure and diabetes. But psychological stressful situations such as grief or bullying also trigger a heart-stressing reaction even in patients without a previous illness. A conscious handling of (emotional) stress is important for the prevention of cardiovascular diseases.

Mentally stressful situations increase the risk of heart attacks, even in healthy people. A conscious handling of (emotional) stress is important for the prevention of cardiovascular diseases. (Image: BillionPhotos.com/fotolia.com)

Interpersonal stress in particular can be problematic

As the German Society for Cardiology - Heart and Circulatory Research (DGK) writes in a current press release, enormous psychological stressful situations increase the risk of myocardial infarction not only in patients with pre-existing coronary heart disease, but also in patients without proven coronary artery disease.

The spectrum of such extreme stressful situations can therefore range from bereavement in the family to bullying at work.

According to the experts, it is particularly striking that the stress-related heart attack is mainly triggered by emotional stress caused by interpersonal problems.

"The usual everyday stress such as a missed tram is by no means as relevant as interpersonal stress, for example with work colleagues, the partner or the family", says Prof. Dr. med. Christiane Waller, spokeswoman for the DGK working group on psychosocial cardiology.

Emotionally upsetting events can put a strain on the heart

According to the DGK, emotionally disturbing events lead to an alarm reaction in the body: the stress hormones and the sympathetic nervous system are activated.

This has a negative effect on the cardiovascular system. The cardiac output increases, the heart muscle needs more oxygen and the heartbeat accelerates.

Because the blood vessels constrict as a reaction to the stressful situation and a critical increase in blood pressure occurs, the heart and blood vessels are heavily stressed.

White blood cells are activated and there is an increased agglutination of blood platelets.

"All of these factors together and many other cellular phenomena explain why a heart attack can more easily occur when you are under stress," said Prof. Dr. med. Hugo Katus, President of the German Society for Cardiology.

"This particularly often affects patients who already have coronary artery disease, but it can also affect people who do not have any significant cardiovascular disease," said the expert.

Many possible causes of heart attack

A heart attack can have many causes. Classic myocardial infarction arises from a pre-existing disease of the coronary arteries and an occlusion of the coronary artery due to the formation of a clot on an arterioscleotic deposit (type 1 myocardial infarction).

According to the DGK, 20-30 percent of all heart attacks do not have any occlusions in the coronary arteries. The heart muscle has a critical oxygen debt due to insufficient blood flow to meet the oxygen demand.

In cardiology, this is called a type 2 heart attack. In this infarction, too, the angina pectoris symptoms (chest pain) and many clinical findings are identical to a classic myocardial infarction, which is caused by a complete vascular occlusion.

However, the patients whose coronary arteries do not show any critical constrictions despite a heart attack are puzzling.

The cause of the infarction in these people has not yet been clarified, but could be a cramping of the vessels (spasm). According to the information, this phenomenon is called MINOCA.

A particular cause of an acute illness resembling a heart attack is the so-called broken heart syndrome.

This disease, which is no less life-threatening than a heart attack, is found in around two to three percent of all patients with suspected myocardial infarction.

This disease, which is particularly common in post-menopausal women, is also called Tako-Tsubo syndrome or stress cardiomyopathy.

The triggers are often extreme emotional stress but also life-threatening situations.

Measures to reduce stress

The DGK points out that the acute treatment of stress-related heart attacks does not differ from that of typical heart attacks.

However, specialists should not disregard the triggering psychosomatic factors, especially in the follow-up care of those affected, so that they can take appropriate measures to reduce stress.

Which these are depends on the individual needs of the individual patient.

“Some reduce stress by doing physical activity. We then advise these patients to exercise, while other patients tend to need rest, ”explained Waller.

“Tai Chi, Chi Gong or mindfulness-based procedures are currently particularly popular as relaxation techniques. But many people also find it helpful to simply read a good book. "

Still the number one cause of death in Europe

But less existential stress can also increase the risk of heart attacks.

Scientists from Munich were able to show that the number of heart attacks during the soccer world championship games of the German team has increased significantly.

While the mortality rate for the different types of heart attacks, according to Prof. Dr. Katus is essentially comparable, registry data after situations with high stress levels, such as earthquakes, show that stress-triggered heart attacks are associated with more complications and larger heart attacks.

So far, however, it is unclear whether heart attacks have different mortality rates depending on the specific trigger situation.

In general, a healthy lifestyle is extremely important in preventing cardiovascular events.

This also includes dealing with stressful situations as consciously as possible. Because cardiovascular diseases are still the number one cause of death in Europe. (ad)

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