Every playoff season, I get asked about the impact of stress on the human heart. The joys and heartbreak of watching your team win, then lose,\u00a0then snatch victory from the jaws of defeat\u00a0can\u00a0strain even the stoutest heart. But in the medical field, the\u00a0impact of stress on the heart is harder to gauge.\u00a0\u00a0<\/p>\n
There is a\u00a0real\u00a0condition called\u00a0broken\u00a0heart\u00a0syndrome, formally called\u00a0stress induced\u00a0cardiomyopathy or\u00a0Takotsubo cardiomyopathy. Though not\u00a0completely understood, it\u00a0seems to be\u00a0caused\u00a0by the sudden surge of stress hormones after an intense stressful episode.\u00a0<\/p>\n
Importantly, the heart failure seen with Takotsubo cardiomyopathy is not caused by a heart attack. Although the symptoms\u00a0of\u00a0chest pain or shortness of breath\u00a0feel\u00a0similar, the\u00a0heart\u2019s\u00a0arteries are clear when checked after the fact. Treatment and\u00a0short-term\u00a0management\u00a0is\u00a0the same, minus the blood thinners as there is no blockage.<\/p>\n
Most people, vaguely remembering the plot of King Lear from high school, assume that\u00a0you would die of\u00a0broken\u00a0heart\u00a0syndrome. But the prognosis is surprisingly\u00a0good. With treatment, heart function returns to normal in most people.\u00a0<\/p>\n
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Some fans, like this one at the Bell Centre viewing event, found Game 7 hard to watch. Relax, advises Dr. Christopher Labos. \u201cThe millionaires\u00a0playing professional hockey for your entertainment are going to be fine no matter what happens.\u201d John Kenney \/ Montreal Gazette<\/p>\n
Takotsubo cardiomyopathy is rare\u00a0relative\u00a0to heart attacks caused by blocked arteries. Here, the standard risk factors are clear. Age, smoking, high blood pressure, diabetes, cholesterol, sedentary lifestyles and diet drive much of cardiac risk. But not all risk is explainable through these factors,\u00a0and researchers have tried to evaluate the impact of stress on the development of atherosclerosis.\u00a0<\/p>\n
The issue is hard to study for several reasons. Stress\u00a0cannot be objectively measured like blood pressure and is inherently subjective and variable.\u00a0It\u2019s\u00a0also hard to\u00a0tease out\u00a0whether stress directly affects the heart or is just linked to less sleep, more snacking, less\u00a0exercise\u00a0and more smoking. It may just be driving unhealthy habits rather than having a direct impact.\u00a0<\/p>\n
The\u00a0INTERHEART\u00a0study<\/a>, a database of tens of thousands of patients across 52 studies,\u00a0attempted\u00a0to answer these questions. They asked people to report the\u00a0presence\u00a0of work stress, financial stress, home\u00a0stress\u00a0and stressful life events in their lives. All four were associated with cardiovascular disease and increased the odds of heart\u00a0attack\u00a0by 30 to 50 per cent.<\/p>\n However, put another way, the increase was actually quite modest. The presence of financial stress rose from 12.2 per cent in controls to 14.6 per cent in heart attack patients. The presence of work stress was 5.1 percentage points higher, home stress 3 percentage points higher, and stressful life events 3.1 percentage points higher in heart attack patients than in controls.\u00a0\u00a0<\/p>\n But most people want to know if\u00a0a\u00a0sudden episode of anger,\u00a0say from\u00a0seeing a missed shot on goal, will trigger a heart\u00a0attack \u2014 thus causing you to head to the emergency room and miss the final period of the game.<\/p>\n
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