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Heart failure

Stress and heart failure

Although stress is not a direct risk factor for cardiovascular disease, the ways that people cope with stress may contribute to an increased risk of heart problems. For instance, some people cope through risky behaviours such as smoking, drinking too much alcohol and overeating, all of which increase the risk of heart disease. 

Some of those we talked to thought that stress had played an important part in the build-up to their heart problems. Others
felt it may have contributed but was perhaps not as important as smoking or having the 'wrong' genes. One man was of the opinion that stress was a 'modern word' used by those who wouldn't slow down.

 

He lives a stress-free life and says that stress is a modern word.

He lives a stress-free life and says that stress is a modern word.

Age at interview: 46
Sex: Male
Age at diagnosis: 45
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Actually, I've never, how can I put it? I've never thought of stress like I don't know, probably martial arts training, I never sort of had you know, you can see situations and you just say 'yeah', you know I just blow it over the wing, you know what I mean?  Because it ain't going to effect me because you're not involved. So stress, I live a stress free life actually, you know what I mean?  

Anybody comes in here and gives me stress; they're back out the front door, 'cos I don't want it in here, you know what I mean. No need for it!  So stress, no. It's a modern word, love! [laughs] It's a modern word for people who won't stop working for a couple of minutes!  I'm sorry but I don't care. You know my parents grew up and if they had the stress that I see people having now, oh gosh, oh my gosh. Stress free man, you know, wherever, you know what I mean?  

Many people were sure that stress had played a central role in the development of their heart problems and that over time it had weakened their heart. Some talked about feeling 'stressed' at work, about having too much responsibility and too much to do. Some said they had worked too hard physically for many years or that they had worked in a poor environment where there was dust and artificial light. Working anti-social hours and shift work were also thought to be stressful and therefore detrimental to health and well-being. Although smoking is known to be an important cause of heart disease, a man who had experienced business and financial difficulties felt that stress had been as much to blame for his heart problems as smoking.

 

He believes his heart attack was caused more by stress than smoking.

He believes his heart attack was caused more by stress than smoking.

Age at interview: 65
Sex: Male
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It would have been after that first attack when I was in hospital the first time. After I had the intensive care, initial intensive care treatment when I eventually came around I asked, I think, I presume you know, 'what's happened to me?' and I was told then that yes, I'd had a heart attack [coughs] - excuse me - which comes as quite a shock at my age. And my doctor at the time said 'Oh dear I'm 40, when is it my turn?' People then asked me why I thought I may have had one. I think this differs with everybody but in my opinion, mine was definitely stress.

Going back was the same, led me to the same problem that I had when I first left. My ambition for when I left school was to go into my father's business but I fell out with his partner. Here I was going back into the same business with my father's partner. It lasted two years before, to the best of my knowledge from what people said, I was on the point of a nervous breakdown. I couldn't take it any more and I walked out.

But that stayed with me for quite some time the stress, or the feeling of stress I think I had in trying to keep the business going, to make ends meet because obviously I did go back on a very much lower salary. Still had a family to support, it was difficult. And I think the worry of my parents leaving the way they did when they did, plus the fact of marriage, children of my own, an awful lot went on in a very short space of time. So I think yes, it was stress, I'm not saying that is the case for everybody. It could be smoking too much, whatever, but in my opinion that's what caused mine. 
 
Life events such as divorce, separation and financial pressures can caused a lot of emotional stress and were mentioned as things that led to people’s health deteriorating. 
 

Mahendra explains that divorced, hard work and rheumatic fever have all contributed to his ill health.

Mahendra explains that divorced, hard work and rheumatic fever have all contributed to his ill health.

Age at interview: 59
Sex: Male
Age at diagnosis: 40
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That’s when I was divorced here. I had a lot of things piled on top of me and that did, you know, that did put me down completely. I was in. When I went they told me I’ve got to have heart surgery that did it, you know, affect me a lot while I was in hospital.

So you think one of the things that had to do with your heart condition was your personal problems?

Personal life, problems yeah.

Apart from your personal domestic problems at the time do you have any idea of anything else that could have caused your heart problems?

No not particularly, no because I used to sometimes before the heart surgery I was working very hard. I was working 7 days a week and my body got very tired because I had a family at that time and I had to work for my family and that did, you know, slow me down because I was working literally 7 days a week to, you know, to make the ends meet you know because everything to be, you know, because the wife wasn’t working so I had to. I was only the bread earner so I had to work very hard for this. So this is the cause of it, you know.

But did you have rheumatic fever, for instance, when you were younger?

I was told and I asked my mum because I come from East Africa. I came in this country in ’72 and my mum told me that I did have rheumatic fever when I was a baby. And that’s what, you know, that thing, this is what the cause was about it, that I might have a rheumatic fever when I was very, very young. When I was born with that and I had a murmur. 
One man said that his heart attack had been triggered by both the shock of bereavement as well as financial troubles.
 

He believes his heart attack was caused by emotional stress rather than high cholesterol.

He believes his heart attack was caused by emotional stress rather than high cholesterol.

Age at interview: 35
Sex: Male
Age at diagnosis: 35
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Back in 1992 I had a heart attack and it was a result of a tremendous stress accumulated over two years of time, literally tremendous stress. I was very fit, never been a smoker in my lifetime, I was always mild to moderate drinker and very much into sports and activities, all sorts of activities. Just something happened in my life between 1990 and 1992 and it was just too much to cope with and that stress caused a spasm in the heart muscle and it blocked the coronaries for a while and then I had a heart attack, a major heart attack. Of course I was hospitalized straight away for quite a, quite long period. After that they took me through to do an angiogram and they found out three of the coronary arteries were blocked completely. The myocardium was infarcted and part of the LV, there was an aneurysm in it. So they said "You have to rest for a few months," and in 1993 I had the by-pass operation.  

They by-passed three of the coronary grafts, repaired the LV aneurysm but I'm, you know I'm left with the myocardial infarction and now it's about twenty percent of the muscle in the LV, in the left ventricle is dead. I mean it's infarcted, that doesn't function and that's what's caused the heart failure. That's the history of the disease and that's when I first knew about it. It definitely, I mean what I want to stress is the cause of my heart failure wasn't high blood cholesterol, it wasn't fat, I was a fit man, very active, just stress. So that's, that's a very important factor.

I can brief a little bit but like all sorts of things happened to my life in 19, between 1990 and 1992. I lost my father and brother in two weeks time, suddenly we lost all our money, all my father's savings in a bank that collapsed in 1991. My life changed dramatically from a spoilt teenager  to you know someone who had to face all these, the reality of life which I didn't see before. It was, it was beyond description really it was tremendous. There's more of it, I mean there's more detail but just really it will just take you three hours to tell you about it.
 

People defined stress in different ways; for instance one man said he relished the stress of his challenging job but that some of the hassle of everyday life such as running out of petrol or forgetting to collect his wife's dry cleaning could be stressful enough to bring on palpitations.

 

He enjoys the stress of his work but finds everyday hassle stressful.

He enjoys the stress of his work but finds everyday hassle stressful.

Age at interview: 62
Sex: Male
Age at diagnosis: 56
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Deadlines, really are the sort of thing that induce stress. There can be several deadlines all at once which are not of your making, in other words the sort of job I do, is not a straight-line job, it's a circular one that people can approach from any direction at any time without warning. Which I love, I love, that's the sort of life I like, you know I'm not a straight-line thinker, I'm a complete free thinker in that respect so the sort of job I do, I enjoy. 5 different problems on different subjects simultaneously is marvellous, but when they all come together at the same point and one's wife says, 'Don't forget to go to the cleaners, I've got to have my dress by tea-time', that is stress!

Or it can be, or you get to the cleaners but you can't park the car and they've dug up half the car park so there's twice as many cars circulating around, you know the sort of thing?  It happens but that is the sort of thing that, you know you start grinding your teeth and the palpitations can start. But the thing is, is not to do it and you learn not to do that. Before you didn't, one would give free range to one's thing but now you just say 'it doesn't matter'. It's a sort of mantra, 'it doesn't really matter'. 

People also talked about feeling extremely anxious about themselves and their illness, (see 'Bad days, anxiety and depression'). One man felt so anxious about being ill at night that he was reluctant to be alone. Someone else said that worrying about things beyond her control could 'eat away' at her.

 

He can feel insecure and anxious at night unless his girlfriend is with him.

He can feel insecure and anxious at night unless his girlfriend is with him.

Age at interview: 54
Sex: Male
Age at diagnosis: 49
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Yes I live on my own but in a way, that's another thing after the third heart attack... because the, when everything is happening early in a morning that is one of the things, well not early but you know about 7 o'clock, 8 o'clock in  the morning or something, which is very difficult to get hold of anyone and there I feel some kind of insecurity when I sleep at night. So though I got my flat and everything, most of the nights I stay with my girlfriend, who lives in a different place, so I'm there almost every night. That gives some kind of security, and I feel it myself, if she's not there I stay till 1 or 2 o'clock in a morning or 3 o'clock in a morning. If she is there by 11 o'clock I am sleeping, and thank God she's always there! [laughs].

So you actually get a better night's sleep?

Yes

You're more relaxed if you're with someone?

With someone yes. This is very, very important because it's all kind of thinking in your mind, what would happen with this... I when I go to bed if I'm well, you know I get, make sure the telephone is there, make sure the spray is there and this nitrate spray, spray for the heart problem is there, and this sort of thing is a kind of security. 


 

Last reviewed April 2016.
Last updated April 2016.

 

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