Acute Stress and Heart Attacks
Acute stress is a sudden, intense reaction to pressure or a threat. It comes on quickly and activates the body’s fight-or-flight response to address the issue or to run from it.
When acute stress hits, the body releases stress hormones such as adrenaline and cortisol, says Michael Blaha, MD, a cardiologist at Johns Hopkins Medicine in Baltimore. Together, they raise your heart rate, cause blood-pressure increases, and constrict blood vessels.
These factors — especially when you already have a buildup of plaque in your arteries — can lead to a heart attack in certain situations, he says.
When stress hits, you may first notice an increase in your heart rate, he says. Although a faster heart rate alone isn’t necessarily dangerous, it reflects how hard you are pushing your cardiovascular system at that moment.
As stress hormones cause your heart to beat faster, they also increase blood pressure and narrow blood vessels, called vasoconstriction.
“Blood vessels constrict to help maintain blood pressure during danger, and that’s a normal and important function,” Blaha says.
For people who already have plaque buildup in their arteries, acute stress can push an already vulnerable system toward a heart attack.
“If someone has a lot of plaque in their arteries already, stress can raise blood pressure, increase clotting, and worsen blood flow all at once,” Blaha says.
In less common cases, vasoconstriction or coronary artery spasms alone may limit enough blood flow to the heart to damage it.
“I’ve seen people who don’t have significant plaque or traditional risk factors develop a small heart attack during extreme stress,” Blaha says.