Emotional stress can also cause heart attacks

Myocardial Infarction: Mental stress situations as triggers are underestimated

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

Increased risk of heart attack through grief or bullying

Most people are aware that the risk of heart attack and other heart disease is increased by factors such as overweight or obesity, high blood pressure and diabetes. But mental stress situations such as grief or bullying trigger a heart-burdening reaction even in patients without previous illness. A conscious handling of (emotional) stress is important for the prevention of cardiovascular diseases.

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

Especially interpersonal stress can be problematic

As the German Society for Cardiology - Cardiovascular Research (DGK) writes in a recent release, enormous mental stress situations increase the risk of heart attack not only in patients with existing coronary heart disease, but also in patients with no proven pre-existing disease in the coronary arteries.

The spectrum of such extreme stress situations can therefore range from bereavement in the family to bullying in the workplace.

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

"The usual everyday stress such as a missed tram is for a long time not as relevant as interpersonal stress, for example with work colleagues, the partner or the family," says Prof. Dr. med. med. Christiane Waller, spokeswoman for the DGK working group Psychosocial Cardiology.

Emotionally disturbing events can burden the heart

According to the DGK, emotionally disturbing events lead to an alarm reaction of 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 vessels narrow in response to the stress situation and there is a critical increase in blood pressure, the heart and vessels are heavily loaded.

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

"All these factors together and many other cellular phenomena explain well why stress can make it easier to have a heart attack," said Prof. Dr. med. med. Hugo Katus, President of the German Cardiac Society.

"This is especially common in patients who already have existing coronary heart disease, but it can also affect people who have no significant cardiovascular disease," said the expert.

Many causes of heart attack possible

A heart attack can have many causes. Classical myocardial infarction is caused by pre-existing coronary heart disease and occlusion of the coronary artery by clot formation on an arterioscotic deposit (type 1 myocardial infarction).

According to the DGK, 20-30 percent of all heart attacks do not contain any occlusions of coronary vessels. Here, a critical oxygen debt of the heart muscle is created by an insufficient for oxygen demand circulation.

In cardiology is then spoken of a type 2 heart attack. Also in this infarction are the angina pectoris complaints (pain in the chest) and many clinical findings with a classic heart attack, which is due to a complete vascular occlusion identical.

However, the patients whose coronary arteries despite heart attack have no critical bottlenecks, puzzles.

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

A particular cause of a heart attack-like acute illness is the so-called Broken Heart Syndrome.

In about two to three percent of all patients with suspected heart attack this disease is found, which is no less life-threatening than a heart attack.

This condition, which is particularly prevalent in postmenopausal 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 the typical heart attacks.

But specialists should not ignore the triggering psychosomatic factors, especially in the aftercare 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 of them reduce stress by exercising physically. We then advise these patients to do physical activity, while other patients are more likely to need rest, "said Waller.

"Especially popular are Tai Chi, Chi Gong or mindfulness-based techniques as relaxation techniques. But it also helps many to read a good book. "

Still the number one cause of death in Europe

But even less existential stress can increase the risk of heart attack.

For example, scientists from Munich were able to show that the number of heart attacks during the World Cup matches of the German team has risen significantly.

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

However, it is still unclear whether heart attacks have different mortality rates depending on the specific trigger situation.

In general, a healthy lifestyle is extremely important for the prevention of cardiovascular events.

This includes, among other things, the most conscious handling possible of stressful situations. Because cardiovascular diseases are still the number one cause of death in Europe. (Ad)