Bob’s Story: Chest Pain Was Like a ‘Sledgehammer’

As Bob was climbing a hill last summer, a severe pain in his chest brought him to his knees.

“It was like being hit with a sledgehammer,” the 67-year-old retired construction equipment operator says.

Bob had a history of high blood pressure. He also had occasional recurring chest pain and shortness of breath that was brought on by activity and relieved by rest. But now, the pain was intense and it scared him. His wife Arline insisted he see his primary care doctor who referred him to a cardiologist. Bob was not satisfied when he learned that the process of testing and getting results could take weeks. “I’m in pain and I need help right now,” Bob told her.

By searching on the Internet, Arline found a link to the Rush Outpatient Chest Pain Center where patients can come in, have a thorough evaluation completed in the morning and then meet with the doctor and get results by the afternoon. “What impressed me the most is you go in there and it’s all done in one day so I called and made an appointment,” Bob says.

At his Monday morning appointment, Bob first met with interventional cardiologist Gary Schaer, MD. He then had a complete work-up, including a treadmill stress echocardiogram to evaluate his heart and valve function at rest and with exertion, which yielded problematic results. Schaer discussed these results with Bob and told him that they needed to perform cardiac catheterization, a procedure to examine blood flow to his heart and test how well his heart was pumping. Bob was scheduled to have the procedure the following day.

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Can Stress Cause a Heart Attack?

Can stress cause a heart attack?By Jill Waite Goldberg

Stress can trigger insomnia, exacerbate digestive problems and cause muscle tension that leads to body aches. But can stress cause a heart attack? Or is it just a dire, unsubstantiated warning offered by concerned family and friends along the lines of “You’ll catch pneumonia if you go outside with your hair wet”?

When faced with a stressful situation (known as acute stress) — such as rush-hour traffic or babysitting an ornery grandchild — our bodies release hormones, including cortisol and adrenaline, which help us react to the situation. These hormones increase heart rate and blood pressure, supplying the body with a burst of energy and strength. This creates a “fight or flight” reaction that, when you’re in actual danger, helps you defend yourself or flee. When the “danger” or stressful scenario passes, the body’s relaxation response kicks in and hormone levels return to normal.

Stress and Heart Health

“In a person with a healthy cardiovascular system, this surge shouldn’t be a problem,” says Rami Doukky, MD, a cardiologist at Rush. However, if there is underlying heart disease, the sudden increase in blood pressure and heart rate could contribute to events leading to a heart attack. For example, in people with atherosclerosis, or cholesterol buildup in their arteries, the increase could cause plaque to rupture and block blood flow, which could result in a heart attack. The surge can also expose people with existing heart disease to the risk of an arrhythmia, which is an irregular heartbeat.

“There is no solid evidence that stress can directly cause a heart attack,” says Doukky. “However, chronic stress — the kind of stress that’s due to ongoing situations like a bad relationship or difficult job — can lead to risk factors that affect heart health.”

Chronic stress has been linked to overeating (which can result in obesity), poor sleep habits and tobacco and alcohol use — practices that could translate into high blood pressure, a major risk factor for cardiovascular disease as well as diabetes. For older adults, who are already at a higher risk for heart disease because of progressive atherosclerosis associated with aging, stress may increase their chances of developing heart disease, Doukky says. Continue reading