The heart-mind connection: How stress can lead to a heart attack

The head-heart connection is a lot stronger than you might think.

While we all know how stress can be a contributing factor to heart disease, you may not realize that stress alone can stop blood flow to the heart.

In the rainy winter of 2020, 70-year-old Maria Fernandez of Yucaipa was digging in her backyard to prevent potential floodwaters. Acute chest pain stopped her.

"I came inside and I sat down, and I got quiet, and it went away," Fernandez said. "But the next morning, while I was cooking breakfast, out of nowhere, the pain in my heart was unbearable. It was tremendous."

In the ER, scans did not show any blockages. But she was having a heart attack.

"Because of the stress, these small vessels tighten. It's what we call spasm," said cardiologist Dr. Purvi Parwani with Loma Linda University Health. She specializes in MINOCA, or myocardial infarction with non-obstructive coronary arteries.

They account for up to 10% of acute heart attacks affecting more women than men.

"Stress definitely affects women more," Parwani said. "We know that it's the stress that affects our microvasculature, and it can lead to sudden increase in the blood pressure and sudden increase in the heart rate."

As a caregiver to both her mother and husband, Fernandez had been suffering from chronic stress for years.

"I never imagined that it would have such an impact on my health, on my heart," she said.

Parwani helped Fernandez manage her stress. She prescribed daily exercise, finding a joyful hobby and deep breathing.

"Meditation. You know, 20 minutes, twice a day of mindfulness," Parwani said. "Mindful meditation can really help."

Fernandez has also learned to eliminate stressful situations such as rushing to get to doctors' appointments. She says small changes have made a huge difference.

"It helps me relax, and it helps me get there on time. And I'm not stressed," Fernandez said.