Heart on High Alert: When Stress Becomes a Real Threat

In wartime, we see an increase in the number of cardiac events in the general population. Accumulated psychological stress activates the sympathetic nervous system, which triggers the fight-or-flight response when we sense danger or threat, preparing the body for immediate action. This response occurs naturally and causes a sharp increase in stress hormones in the body, primarily adrenaline and cortisol. Under conditions of chronic stress, this system is always on. The heart and blood vessels are put under excessive strain, which can lead to high blood pressure, heart attacks, arrhythmias and more," stated Prof. Abu Fanne, Director of the Catheterization Unit at Hillel Yaffe Medical Center.

"Heightened psychological stress can lead to a heart attack"

A spike in heart rate and blood pressure can cause an atherosclerotic plaque or the lining of a coronary artery to rupture, leading to the formation of a blood clot that may result in a heart attack. In other cases, even without arterial blockage, sudden spasm of the coronary blood vessels slows blood flow to the heart muscle and can cause sharp chest pain or a heart attack. Another factor that may trigger a heart attack is increased blood clotting, in other words, when the blood becomes more "viscous.” Additionally, ongoing or recurrent stress can lead to inflammation that damages the blood vessels, sometimes to the point of a sudden tear in the inner lining of an artery. 

Prof. Abu Fanne

"Broken Heart Syndrome”

Dr. Maggie Barel, Director of the Cardiac Intensive Care Unit at Hillel Yaffe, noted that during the Iron Swords War, several women experienced this condition. "This is a well-known phenomenon, particularly among women of menopausal age. We had mothers of sons fighting in Gaza admitted to our unit. Women who were otherwise healthy who developed the syndrome. It involves intense, sudden pressure in the chest that can weaken the heart muscle, without any specific problem in the coronary arteries." 

Who is at risk?

Certain people are at greater risk of having a heart attack during periods of prolonged stress and tension. These include people with high blood pressure, a prior history of heart problems, diabetes or obesity; smokers, who tend to smoke more heavily when under stress; people with sleep disorders, particularly obstructive sleep apnea; and shift workers. Women going through menopause are also more vulnerable to Broken Heart Syndrome. • Watch for these warning signs 

Prof. Ariel Roguin, Director of the Cardiac Division, emphasizes that symptoms can present differently from person to person. Some people will feel pressure or heaviness in the chest; others may experience shortness of breath, jaw or arm pain, sudden dizziness or nausea. If you notice one or more of these symptoms, take them seriously and seek medical attention promptly, as stress-induced cardiac events can deteriorate quickly.

"Managing stress"

Stress can be eased and kept in check through a combination of approaches - walking, meditation, breathing exercises, adequate sleep, maintaining a positive mood and a sense of humor, social support (especially in older age), reducing caffeine and alcohol intake, and completely avoiding smoking and energy drinks. It's worth emphasizing that regular physical exercise dramatically increases the heart's resilience to the effects of stress, which is why it's important to find an activity you enjoy and can sustain over time. Patients with risk factors must keep up with routine cardiac check-ups and take their medications consistently and should seek medical attention if they feel unwell. 

"Stress is an integral part of modern life, but we need to be aware of its direct impact on heart health and take preventive measures. Adopting a healthy lifestyle, getting regular check-ups, and seeking medical advice when needed are critical to reducing the risk of stress-induced cardiac events," concluded Prof. Abu Fanne.