Emotional or psychological stress is one of the most prevailing mental health issues with minute attention to cause and treatment in Pakistan. Emotional stress even if it’s acute or chronic eventually leaves a strong and negative impact on human heart health.
By Shahzadi Arhum , Dr. Muhammad Mustafa
Introduction and Types of Emotional stress
Recent studies have shown that any kind of psychological stress leaves a prolonged impact on the human body. These types include anxiety, stress, depression, work-related stress, anger, hostility, and even pessimism. Which concludes that “Emotional stress causes cardiac complications”.
This emotional or psychological stress can be due to social stress markers and emotions as well. Society and the surroundings usually make the basis of any kind of psychological stress which is exacerbated by stress factors. These stressors have psychological effects on cardiovascular diseases (CVD). In most cases, they act as triggering agents of cardiovascular disease . Whether directly or indirectly these stressors or stress agents lead your heart towards various deadly complications.
Emotional stress and associated cardiac complications
In direct cases, sudden emotional stress usually causes various types of arrhythmias. These arrhythmias are the disruption in the cardiac rate or rhythm which can either exacerbate slowly. In some circumstances, under severe kind of emotional stress, this rhythm does not go back to normal heart rate. This is when the heart’s pump stops working properly, and the heart may go into arrest. In the case of the indirect impact of emotional stress, the individual may develop hypertension. Hypertension slowly progresses toward various diseases including cardiac failures and arrest. Not just hypertension there are many other kinds of health issues that may contribute to the progression of cardiovascular diseases.
Contributors to emotional stress and cardiac complications
The major psychological factors contributing to cardiac complications due to stress include anger, depression, hostility, work-related stress, Post-traumatic stress disorder (PTSD), anxiety, social isolation and loneliness, and pessimism. Also, any other cause that might act as an initiating or triggering factor or as an exacerbating factor towards emotional stress and eventually cardiac failure. These factors can act individually or collectively. These factors are not just heart but will leave a strong, negative, and long-term issue for the rest of the body. The emotional stress associated with cardiac complications includes hypertension, stroke, coronary heart disease (CHD) and incident myocardial infarction (MI), CVD mortality, coronary artery spasm, incident stroke, heart failure, incident CVD mortality, and CHD, arrhythmias, cardiomyopathies and recurring CHD and CVD. Other emotional stress-associated health issues include obesity, diabetes, stomach issues most probably IBS, hemorrhages, and even renal failure.
Major contributing disease toward cardiac failure is different types of cardiomyopathies. It is a heart muscle disease that makes it hard to pump blood properly. These cardiomyopathies have multiple causing factors including heart attack, arrhythmias, hypertension, etc. Five different types of cardiomyopathies can be hereditary and non-hereditary. These all act as contributors to congestive heart failure also known as heart failure where either heart does not work properly or completely stops working.
Pathways leading to cardiac failure
One of the commonly observed pathways adopted by the body is the arrhythmias associated with heart failure. . In such conditions, the heart’s pump stops working properly. Then the heartbeat becomes either too fast i.e. tachycardia, or too slow i.e., Bradycardia. That is when the pump does not let the heart work at its normal pace. Due to this constant presence of arrhythmias, the heart muscles stop working properly and cardiomyopathies start developing. In individuals with hereditary cardiomyopathies and other cardiac issues, the chances of heart failure due to emotional stress are multiple folds higher as compared to individuals who develop cardiomyopathies due to environmental factors.
Various studies at the molecular level have shown that patients with acute diseases have associated cardiac complications. These complications develop due to the presence of constant emotional stress. To prove this idea multiple studies at the molecular level have been done to investigate the presence of biochemical stress markers in blood samples of such patients. on molecular level it justifies that the emotional stress causes cardiac complications.
Examples from Animal models
Not only in humans these hypotheses have been confirmed in animal models too i.e., in rodents to check the impact of emotional stress on cardiac health. It indicated the impact of long-term emotional stress on heart tissue. The studies show that the heart not only goes towards arrest or failure but also its morphology starts altering and the number of cells starts decreasing with time. Not just that the tissues of the heart start stiffening, and they eventually weaken the heart.
Diagnosis of Emotional stress
In order to diagnose emotional stress in patients with various diseases, multiple approaches are available. One such approach is the stress test. There are three different types of stress tests available i.e., exercise stress test, stress echocardiograms, and nuclear stress tests. Also, another type of such test called as Cardiac stress test is available to monitor heart health where external pharmacological stimuli or exercise is used to check the heart’s ability under a controlled environment where the heart’s response to an external stressor is observed.
Hence, various research studies in human, as well as animal models, have shown a strong correlation between Psychological stress, psychological stressors, stress markers, and various numbers of cardiac complications that might or are deadly to humans. This is where we can claim that emotional stress causes cardiac complications. These stressors or triggering agents can be any surrounding object that might play with your mind and disturb your mental peace.
These stress-causing agents are not just bound to these specific numbers or examples. They also vary from person to person and gender to gender. A stressor that might be nothing for an individual can be a strong triggering agent for another person. That is when humans should be more considerate towards each other. Sometimes a person with a very friendly vibe or a person with a happy personality may be under severe kind of emotional stress which might trigger cardiac issues. There is a need to develop biological markers to diagnose emotional stress, since psychiatric symptoms are complex and provide estimates. We all believe that mental health is related to biological responses of body but the underline mechanism to find the cross talk between two is important. Effect of poor mental health on brain plasticity steer neural structure genes to initiate the cascade of events which defines how human biology will cope and respond to emotional stress. Prolonged stress will keep brain on the toes, consuming brain functions and depleting its resources to tackle regular body functions. Identification of novel emotional stress bio-markers will help physicians for effective treatment in cardiovascular diseases as well as provide therapeutic targets to minimize the impact of emotional stress on human health.
(This article is co-authored by Shahzadi Arhum and Dr. Muhammad Mustafa)
Forman Christian College University, Lahore Pakistan