Women have many stress hormone receptors in their arteries and cardiac muscle for hormones called catecholamines. Their coronary arteries (arteries irrigating the heart) are also smaller than men’s. All of this makes women more vulnerable to coronary artery spasms where stress triggers an artery to tighten, increasing the risk for a heart attack. There are so many stressful things to navigate during this health crisis and so many questions with no good answers: isn’t it risky for my kids to go to school? when will life get back to normal? what financial impact will this have on my job? where can we go on vacation? With many people still working from home, all the extra time together has put a strain on families and couples. All of this pressure is generating chronic stress. This stress activates the sympathetic nervous system and stimulates cortisol secretion, which weakens the immune system and organs. Chronic stress is one of the primary cardiovascular risk factors for women, along with tobacco use. People subjected to chronic stress tend to gain weight, neglect physical activity and turn to tobacco and alcohol for comfort. But these coping mechanisms are deceptive: they make you feel like you’re relaxing, but actually generate more stress. Stress is particularly harmful for women in unstable financial situations who have to deal with even more pressure. Women who are unemployed are more likely to smoke (45%), consume too much alcohol (13.8%) and struggle with obesity (35.1%) (source: Haut Conseil à l’Égalité entre les Femmes et les Hommes). The more of these risk factors a person has, the higher her risk of experiencing a cardiovascular event. There are many sources of major acute stress, like severe anxiety, bad news or an especially painful situation. They can sometimes trigger an acute cardiac event, known as broken heart syndrome, takotsubo cardiomyopathy or stress cardiomyopathy. Women are four times more likely than men to experience symptoms that mimic a heart attack. Most often, women who experience this are in menopause. The symptoms seem like a heart attack: intense chest pain radiating into the arms and jaw, and sometimes nausea and vomiting, palpitations and loss of consciousness. But what’s happening is actually a form of acute heart failure. Intense stress triggers a sudden release of stress hormones called catecholamines. They paralyze the heart, causing it to practically stop beating so that it can no longer send blood into our body’s arteries. Emergency medical imaging (cardiac ultrasound or MRI) will show a heart that has the characteristic shape of an amphora vase or an octopus trap (tako-stubo in Japanese). If the patient receives appropriate timely treatment in a cardiac intensive care unit, broken heart syndrome is usually reversible within a few weeks. But we aren’t doomed to suffer the effects of severe stress. Here are ways to mitigate them:
• exercise regularly
• take time for regular relaxation
• listen to music
• strengthen social ties by staying in touch with your loved ones
• avoid alcohol and tobacco
• take a quick nap after lunch
• practice cardiac coherence breathing exercises or mindfulness meditation
• laugh several times per day
• try laughter yoga
• sleep seven to eight hours per night
• eat a balanced meal at set times with your family