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.

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.

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.

I am not sure what your response is to this, but let me tell you my gut feeling. Allowing people the ability to take a drug in order to lower their cholesterol is a pure enabler of promoting illness. It is not like an allergy pill. It is a true medication to decrease the onset of heart disease and to stabilize plaque in those patients with risk factors of heart disease or high cholesterol. If we give all Americans permission to medicate themselves, we are sending a message of defeat, complacency, and acceptance of illness as the norm. Instead of promoting diet and exercise, and empowering people to change their habits to become healthier, we are giving them the option to pop a pill. Not only that, these medications are metabolized by the liver, and can increase liver function tests and require discontinuation. In fact, we have heard more and more about Tylenol poisoning from people overdosing on the simple over-the-counter acetaminophen that has caused death in excess. With multiple medications, all metabolized by the liver, the risks go up. Instead of seeing health, I believe in so many ways that this is a set up for worse outcomes.

Sometimes plans that seem to be the most cost-effective in medicine are the most dangerous. The truth is, it’s often better to put your heart and health in your doctor’s care instead of your own.

In a recent study published in the European Heart Journal, “life satisfaction” was responsible for a reduced risk of heart disease. In a study of 8,000 British civil servants over a six year period, there was a 13% reduced risk of coronary artery disease with life satisfaction in four main areas: job, family, sex, and self. When we look at our lives, it is important to try and achieve some balance. Self-care is equally as critical as caring for our families and our jobs. So often, women place themselves last after caring for their children, loved ones, and their work. For all of us, we get caught up in the stress of life and forget to actually live. Balancing those four areas can lead to true life satisfaction.

Stress has been implicated in the development of heart disease, as well. With the release of stress hormones, such as cortisol and epinephrine, there is also a tendency for inflammation, and the potential development of other issues. Irregular heart rhythms, high blood pressure, high cholesterol, and even obesity can result from stress. We all have it, and have to deal with it on a daily basis, whether it be through exercise, meditation, or simply breathing.

I decided to not only read the reports, but last week I tried to live them as well. I strove for stress management, and for life satisfaction. I prescribe it to all of you. It was absolutely worth it. We all need to learn to balance, to practice self care, and every so often, to shut off the electronics.

This week I had the opportunity to take an exercise class, and for one hour got my heart rate up and sweated all the way through. The next day, I could barely get out of bed, as I felt dizzy and lightheaded. It took a bit of time, but I had the same epiphany.

The previous recommendations have been 8 glasses of water a day, but studies have shown that people who allow their thirst to guide them often get enough hydration throughout the day. Hydration can come in the form of water, other beverages, and also foods. Per day in both fluids and in food, 91 ounces is recommended for women, and 125 ounces is recommended for men.

It is important to replenish our body’s fluids from sweating due to the hot weather. Simply drinking water is the best way to re-hydrate. Pay attention to whether or not you are thirsty, or feel a bit “out of sorts”. My advice? Grab a tall glass of water. It seems to be the cure this week. It is hot out there… make sure you don’t forget to drink water!

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. viagra

That being said, in a study of 14,000 patients, ages 24 to 32 years old, there is a 19% incidence of high blood pressure. This has increased from 4% in 2007 to 2008. The reality is that if we do not control the development of these staggering statistics, we are going to see heart disease in younger and younger people. Join the Young Professionals in spreading the word. The best way to start is with yourself… go get your own blood pressure checked today, and let’s redefine heart disease as heart health, one heart at a time.