Monday March 30, 2020

Find out How Mental Stress Can Trigger Heart Attack

Mental stress and not physicals stress may trigger a second heart attack

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Mental stress heart
Mental stress may be a stronger predictor of a repeat heart attack or even dying from heart disease. Pixabay

For those who have survived a heart attack, mental stress — and not physical stress — may be a stronger predictor of a repeat heart attack or even dying from heart disease, warn researchers.

The team at Emory University investigated whether myocardial ischemia — when blood flow to the heart is reduced such that the heart muscle doesn’t get enough oxygen — induced by mental stress was associated with poor outcomes among heart attack survivors, and how this type of stress testing compares with conventional stress brought on by exercise.

Among more than 300 young and middle-aged individuals enrolled in the study, those who endured myocardial ischemia with mental stress had a two-fold higher likelihood of having another heart attack or dying from heart disease compared with those who did not have cardiac ischemia induced by mental stress.

“In our study, myocardial ischemia provoked by mental stress was a better risk indicator than what we were able to see with conventional stress testing,” said Viola Vaccarino from Emory University’s Rollins School of Public Health in Atlanta and the study’s principal investigator.

Mental stress heart
Mental stress provoked by emotions has a distinct mechanism of risk for heart disease and its complications compared with physical stress. Pixabay

This is the only study of its kind in this relatively young adult population of heart attack survivors.

“These data point to the important effect that psychological stress can have on the heart and on the prognosis of patients with heart disease,” she added.

The investigators studied 306 adults aged 61 years or younger (50 years on average and ranging from 22-61 years), who had been in the hospital for a heart attack in the previous eight months.

Traditional stress tests, in which someone exercises on a treadmill or takes a medicine that makes the heart beat faster and harder as if the person was actually exercising, have long been used to check blood flow to the heart and gauge the risk of heart problems.

Taking into account patients’ psychological stress may help clinicians better evaluate the risk of recurrent heart attacks or death seen in some patients surviving a heart attack.

Overall, mental stress induced myocardial ischemia occurred in 16 per cent of patients and conventional ischemia in 35 per cent, suggesting that traditional ischemia due to exercise or drug-induced stress is more common.

Over a three-year follow-up, 10 per cent of patients (28 individuals) had another heart attack and two died of heart-related problems.

The incidence of heart attack or cardiovascular-related death was more than doubled in patients with mental stress induced ischemia compared with those without mental stress ischemia, occurring in 10 (20 per cent) and 20 (8 per cent) patients, respectively.

Mental stress heart
Among more than 300 young and middle-aged individuals enrolled in the study, those who endured myocardial ischemia with mental stress had a two-fold higher likelihood of having another heart attack or dying from heart disease. Pixabay

“Patients who developed ischemia with mental stress had more than two times the risk of having a repeat heart attack or dying from heart disease compared with those who did not develop ischemia during mental stress,” Vaccarino elaborated.

What this means is that the propensity to have a reduction in blood flow to the heart during acute psychological stress poses substantial future risk to these patients,

Such reduction in blood flow, when it occurs in real life, could trigger a heart attack or serious heart rhythm problems, she said.

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Another interesting finding, according to Vaccarino, is that ischemia with mental stress and with conventional stress were not strongly related to each other, suggesting that they occur through different pathways.

“This points to the fact that stress provoked by emotions has a distinct mechanism of risk for heart disease and its complications compared with physical stress,” she noted. (IANS)

Next Story

Effects of Quarantine on Mental Health and Relationships

Couples in Quarantine: Stress, Anxiety, Fear of the Unknown

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quarantine relationships
Amid the lockdown, family members have united and are spending time with each other. This has improved relationships. Pixabay

With all the havoc it’s wreaking across the globe, the coronavirus outbreak is naturally having an impact on couples and their relationships. Family therapists are conducting sessions remotely as patients are confined to their homes.

They say even the most subtle differences in temperament can be aggravated because of the outbreak’s stress. It’s a time when every domestic decision can seem to have impossibly high stakes, from going to the grocery store to deciding who gets quarantined together.

The 60-something husband works in the food industry and still insists upon leaving every day for work, saying he needs to keep his business afloat. His frightened wife desperately wants him to stay home.

For another couple, in the midst of a separation, the bitterly fought issue is the kids and whether they can safely see friends. One parent is allowing it in an effort to be the “fun parent”; the other bitterly opposes it.

And for still another couple, it’s simply about grocery shopping. She fills the cart, and he accuses her of hoarding unnecessarily. She argues that they need to be prepared.

Scenarios like these are playing out in urban high-rises, suburban homes and tiny rural communities across America as couples try to navigate what has abruptly become the “new normal” during the coronavirus outbreak. Described by therapists, lawyers or the couples themselves, they reveal how even the most subtle differences in temperament or coping strategy can be painfully exacerbated under the incredible stress and anxiety that the outbreak is causing.

quarantine relationships
With all the havoc it’s wreaking across the globe, the coronavirus outbreak is naturally having an impact on couples and their relationships. Pixabay

It’s a time when every domestic decision can seem to have impossibly high stakes, says Catherine Lewis, therapist and faculty member at Ackerman Institute for the Family in New York, from the seemingly small — whether to go grocery shopping — to the fraught calculus of which family members should isolate together.

“This pandemic is making us all think about our relationships, because you really cannot do one thing without it impacting somebody else,,” says Lewis, who’s been conducting therapy sessions remotely. “It’s such a powerful example of how interconnected we all are.”

Added to that, Lewis notes, is the utter helplessness of having no idea how long the situation will last.

She does see some couples finding “that they have a wild capacity to be resilient, to just find a way to move through the day.” On the negative side, it’s clear that people are generally not at their best when under deep stress.

“Normal patterns are intensified,” she says. “There’s increased annoyance, people snapping.”  

Alcohol can become a more frequent coping mechanism. Or worse.

“I’m worried about couples where there is intense aggression,” she says. In cases where there was already domestic abuse, advocates fear a dangerous escalation.

Jennifer Kouzi, a divorce lawyer and mediator, puts it bluntly: “We’re seeing a lot more bad behavior.”

In many cases, there may be no ramifications for bad behavior. One parent, for example, has refused to turn over a child to the other in accordance with their agreement, citing the virus crisis, even though the other parent is taking every precaution. Police have refused to enforce the custody order and recommended the parent go to court, but it’s unclear if judges will deem the case an emergency. In another case Kouzi is aware of involving a separated couple, one parent is allowing their kids to go see friends, “to be the fun parent, so the kids will want to stay there full-time instead of with the parent actually following recommendations and guidelines.” It’s not all grim.

“Some parents have actually risen to the occasion and are communicating better than normal, rearranging schedules and increasing FaceTime access and doing what makes sense” for their kids, she says.

Kouzi, who practices in both New York and in Westchester County, one of its suburbs, is telling her clients to try to use the time productively or to consider mediation.

“There will be such a backlog when courts open up again,” she says.

Some couples are experiencing only minor ripples, if any. Stephanie Pfeiffer, a business systems analyst in Boston, found herself annoyed with her husband when they went food shopping last week, and each time she put something into the cart — two pounds of butter, cans of tuna or tomato soup, a box of crackers — he questioned why.

 

“It’s been like most days,” she reported last week, “except that my husband is leaving dirty dishes and I get to clean up after him, too.” She joked that her spouse had made the mistake of coming down at one point to chat, “and I handed him a baby to put down for a nap. He hasn’t come down since!”

quarantine relationships
A couple bored with the government-required national isolation at home due to the spreading coronavirus, sits in the 5th floor apartment window on a sunny spring day in downtown Warsaw. VOA

Adrienne Pattison, who lives in a rural area of Washington state, joined a Facebook group called “Parenting Under Quarantine” a week ago and wrote: “Is it just me or is anyone else totally frustrated with the husband/partner or whatever?? I’m about to go postal!” Her good-natured venting elicited more than 160 comments and anecdotes.

Maggie Hellman, the Bergenfield, New Jersey, mother who created the Facebook group for her friends to blow off their own steam — she never thought it would balloon to over 20,000 — notes that some couples are, of course, dealing with gravely serious challenges. Her brother, a pediatric intensive care physician, has to come home through a side door to discard dirty clothing and wash his hands to avoid infecting the family. His wife, a nurse, must be extremely careful as well.

Hellman, a social worker and stay-at-home mom, says it’s natural that couples with children are feeling intense stress.

“Children create stress in a marriage, period,” she says. “The relationship changes dramatically.” Under current conditions, she says, “you’re stuck at home all day with each other when perhaps there already were issues.” She imagines that single parents have it even worse, especially if they have only one child.
“They get no break, they have no one else to be with,” she says.

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Lewis, the family therapist, says it’s still early days. She hopes the couples she treats will find a way to deal with the anxiety and uncertainty in a useful way.

Some of her best advice to couples: “Let’s try not to both have a bad day at the same time,” she says. “If today’s your bad day, mine is tomorrow. Let’s not blow at the same time.” (VOA)