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Life’s stress can cause chest pain, palpitations and shortness of breath, and can lead to being Broken-Hearted – it can even make your heart look like it had a heart attack.  In fact, when heart symptoms are dismissed as being “in your head”, it doesn’t make it any less dangerous.

Stress and Heart Damage

Serious stressful situations can lead to temporary heart damage, causing the heart muscle to transiently stop working.  A patient told me about her palpitations and chest pains, and tried to minimize the traumatic events surrounding her life. I asked her to really figure out what was going on, and she down-played all of the issues, as so many of us do every day. After the hurricane struck her home, and she returned to New York to remember her son at Ground Zero, clearly there was more to the story. The shortness of breath, chest pain and palpitations were all signs of the heart damage associated with her cardiomyopathy, as had experienced a massive heart attack.

Mind Heart link

There is a direct link between the mind and the heart, and all those stress hormones or feeling of true angst can take its toll. Palpitations or chest pains can result from simply emotional overload, and may actually lead to abnormal heart rhythms or a dilated heart.  Stress in all forms leads to a rush of hormones, like epinephrine, norepinephrine and cortisol, and when overloaded, palpitations or chest pains might be the first sign that something is truly wrong.

Emotions in Your Head?

We have had quite a summer, with earthquakes and hurricanes and the 10th anniversary of 9/11, when we have all had to pay attention to our hearts in some ways.  We have been tested, and although we will persevere, our hearts have been touched.  Those emotions you are having are not just in your head, they are effecting your heart as well, and it might be trying to tell you something.  There is such a thing as being Broken-Hearted after all.  Take care of it.

September 15, 2011

The truth about “my” heart is often told to me in my office by patients, who behind closed doors will tell me how they really feel, or what is really bothering them, despite the “heart healthy” façade they choose to show to the world. This week was a bit different, the Truth was happening outside of the office too. On Tuesday evening, I joined the American Heart Association’s Go Red for Women screening of Elizabeth Bank’s short film, “Just a Little Heart Attack” depicting a 30-something working mom, getting her children ready for school and while running frantically around and multi-tasking, she suffers a heart attack.

The Truth is, the film was not just about my patients whose stories often shock me, but for the first time, I saw myself and was reminded how we all are vulnerable to heart disease if we don’t pay attention.

We were introduced to 6 survivors whose stories brought tears to our eyes from the woman whose first date jitters were really symptoms of a stroke, to the personal trainer who had a heart attack, to the woman whose mother died in her arms when she was only 16 years old.

All the literature this week in cardiac prevention dealt with the recurring themes of lifestyle decisions and choices, and the importance of exercise and healthy eating. In the midst of my own running between events, taking care of patients and being a mom, I was reminded somewhere in between, that this is as much my own problem as anyone else’s, despite being in the know!

Here’s the Truth about my heart, if I forget about myself because of my own life’s hierarchy, then I know this is happening to all of you. It isn’t THEIR problem; it’s OUR problem, too. Watch the film, and let me know if you see yourself somewhere in there. Then, do me a favor, just breathe and pay attention to your heart for just a little while every single day. It needs your attention, just as much as everyone and everything else.

Four years ago, I met a 43 year old man whose father died of a heart attack at 50 and he wanted a different life and a different outcome. His wife was pregnant and he wanted to stay alive and healthy for his child. We found that he had plaque in his arteries and he started on a strict diet and exercise regimen. He lost 40 pounds, his cholesterol went down and he was well maintained on one blood pressure medication. As life would have it, his baby was born, the stock market crashed and his life spun a bit out of control. He decided that if he couldn’t do it “all”, he wasn’t going to do any of it, and gained the weight back and simply quit trying.
In the ideal world, we would also succeed at this “health game” if we didn’t work, had personal trainers and chefs, and had no stress. The truth is that no matter who you are- celebrity, banker, teacher, baker, chef, mother- WE ALL HAVE STRESS. When doing what is best for us, sometimes we have to compromise. We can do as well as we can, if not the best it can be. We might not be able to work out 5 days a week, but can figure out 3. We might just need to eat that slice of pizza once in awhile, because the kids really wanted it and there is nothing left in the house. We might just have to understand that just trying a little bit, and living life, might be just enough. Giving up totally is not the answer, though.
When trying to be healthy and to take care of yourself, really look at your life and be honest. Who are you, really? What are your limitations and what are your strong points? After you really take an accurate inventory of your life, then start slowly and gradually. Promise yourself to stop the worst thing first and never, ever, no matter what, go back to it. For example, quit drinking soda or give up a muffin for breakfast, and even when your world feels out of control, you just simply never go back to that one thing. Strive for your best and not for your perfect. One day after all those little changes are made, you will realize that you’ve almost reached it anyway.
The patient, now 47 comes in with a new perspective. He is now a father, and nearing the age when his own father died. In talking about life, we chose his one big thing to change. But, first, he has to remember the most important thing, which he forgot, all these changes are completely up to him. No matter how out of control the world may seem. It’s his choice, his life, and he is totally in control. One choice at a time.

I was told by a 42-year-old patient this week that the reason I hadn’t seen her for a year was because she knew something was wrong with her health, but she didn’t want to find out what it was. I stopped talking and just looked at her. I am very rarely speechless, yet in that moment, I didn’t know how to respond. I understood her fears, but we had lost a whole year of her newly diagnosed diabetes being untreated, and her sky-rocketing cholesterol not being managed. She lost a year of her life, and a year of treatment. Sometimes it is easier to close your eyes, bury your head in the sand, and pretend nothing is happening. But the thoughts will still linger in the back of your mind, and not feeling well is not an acceptable alternative.

One of the issues in dealing with your heart is that you can’t see it, and it doesn’t always cause symptoms, even if something is wrong with it. Risk factors of heart disease like high cholesterol, diabetes, or high blood pressure may be happening without you even being aware of it. When the body’s intrinsic system is off kilter, whether due to diabetes or high blood pressure, many times there is a notion that something isn’t quite right. But sometimes it doesn’t feel bad enough to seek out medical attention. This is the reason that prevention, and careful attention to yourself, your body, and your health becomes critical. “Knowing Your Numbers”, as promoted by the American Heart Association, is a way to remind us that it is just important to KNOW. Knowing the critical numbers such as cholesterol levels, sugar levels (hemoglobin A1c), and blood pressure levels help ensure that we maintain healthy arteries and hearts, and that we don’t get sick. It is to make sure that when we think everything is alright, it actually is. Diabetes, high cholesterol, and high blood pressure can linger in the background of your life. Meanwhile it proceeds to damage the lining of your arteries causing atherosclerosis, or affecting the arteries of your kidneys, eyes, or even your brain.

Pretending it isn’t there is not a solution. It is a way of putting off the inevitable. Taking charge of your health puts you in control, instead of allowing a potential illness to take over. When I started to speak to my patient again, all I could say was, “Congratulations!”  She did the greatest thing she could possibly do. She decided to find out, know the truth, and do something about it. Now, she’s going to be just fine.

Much of the nation looks at same-sex marriage as a political issue, and many others look at it as a religious concept, but I simply look at it for what it is. Like many of you, I read the various news clippings and blogs addressing the varied viewpoints of Governor Cuomo passing the marriage equality bill in New York. Some were celebratory, while others had derogatory comments bearing little relevance to the true issue at hand. The reality is that in the United States of America, in order to get married a license is issued by the state. This legal document binds the partnership, as in a business deal. The reality of this is separate from any religious sect or moral code. Yet, this binding commitment somehow seems to have an effect on health. The CDC report between 1999 and 2002 surveyed 127,000 people and their marital status and health. Those people who were married were the healthiest. Interestingly, living with someone did not lead to the same health benefits as those who were married. In fact, their health was significantly worse, and similar to those who were divorced. Some of these issues might be an increase in heart disease, diabetes, depression, stress and a reduction of the immune system. As a physician whose viewpoint is that we all have the right to live with vitality and health by the choices we make, we should allow everyone to follow their hearts and live from the center of it. Apparently, if we allow those people who want to marry the right to marry, then maybe our health care costs would decrease. Now, wouldn’t that be interesting!

Wedding bands image can be found here.