Recovery After a Heart Attack or Surgery / Coping with Stress

Stress and heart disease

How stress can affect your heart

Things that people find stressful

Stress and heart attacks

How do I manage my stress?

Do I need to go for professional Help?


Stress and heart disease

The term ‘stress’ is used to describe the way we feel when too many demands are placed on us or when tensions are high.  People vary in what they find stressful and in the way their symptoms of stress can show. We also vary in how we cope generally with stress; some people may eat more, some people may eat less, some people may try to relax quietly while others may feel they need to do some activity.  Some stress is necessary to stop boredom and poor motivation but if too many things happen at once or go on for too long stress levels can become too high.  We need to get the balance right and identify the things that cause us stress and recognise when they are affecting our health.

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How stress can affect your heart 

The major risk factors for heart disease are smoking, high blood pressure, high blood cholesterol, inactivity, being very overweight, having diabetes and a family history of heart disease.  Stress is not a major risk factor for heart disease, but it is known that stress can affect the heart by releasing certain hormones that increase blood pressure and can encourage clotting in the arteries.  We do know that stress can affect people's attitude to life and encourage less healthy behaviors such as unhealthy eating patterns, excessive drinking and smoking.  Stress can also discourage more healthy pursuits such as relaxation, time for hobbies or physical activity.  There is also some evidence that work stress can contribute to heart disease in some people especially if they feel they have many demands but little personal control.  Therefore although stress may play a part in contributing to some people's heart disease, it is important to remember that stress is not one of the main risk factors.

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Things that people find stressful

Life is full of different types of stress.  Common sources of stress are relationships, work, ill health, money problems and major life events or changes.  Sometimes several life events happen at once and this can tip the balance from coping to not coping.  If every area of your life seems difficult and you have additional symptoms such as persistent low mood over several weeks you may be depressed and may need further counseling help or medication from your GP.  It is important to talk things over with other people (family, friends or a health professional) rather than bottling up your feelings.



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Stress and heart attacks

All illnesses are stressful.  After a heart attack peoples reactions vary and can change over time.  Some people feel so overwhelmed they initially deny their illness. Many people may feel frightened and anxious.   Some people may be angry at why it has happened to them and others may feel a lack of confidence in resuming previous activities and lifestyle. Your practice nurse/cardiac rehabilitation team will be able to reassure you about any specific concerns.  In some people extreme stress can trigger angina pains however it is not true to say that any stress will cause another heart attack.  This mistaken belief if held by you, or your partner, will stop you enjoying or making the most of your life.  Remember boredom and inactivity can be as stressful as having too much to do! 

Common mistaken beliefs:

“Stress caused my heart attack” 
Answer: Although unpleasant it is not one of the major risk factors

“Any exercise will kill me” 
Answer: Check with the cardiac rehab team/practice nurse what you can do safely, but most people will benefit from doing more not less exercise

“Sexual activity will trigger a heart attack” 
Answer: Check with the cardiac rehab team/practice nurse but most people find they can return to the intimate relations they enjoyed before.

“Now I have heart disease my life is over” 
Answer: Most people enjoy good recovery after a heart attack, modern drugs and surgery make heart attacks less of a problem than they used to be.

Talk to your GP or cardiac rehabilitation/practice nurse if you have any concerns. 

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How do I manage my stress?

Identify sources of stress – are there any particular patterns to your stress? Become aware of your body's response to stress, keep a stress diary for 2-4 weeks, who, where and what happened, has this happened before?

Can you tackle the cause of the stress – if it is work related speak to your line manager, look at time management, and reassess your priorities. Some work places have an Occupational Health department to help you.

  • If it is money related speak to Citizens Advice or contact the National Debt Line.
  • If it is family/relationships arrange some quality time to talk things over, reassess your priorities or think about counseling.

Look at things from a different point of view – change the way you respond to stress triggers. Ask yourself - Why am I doing this e.g. is it to feel important, is it to avoid doing something else. What can wait, who else can do it, what are my priorities?

Practice relaxation to control any negative physical symptoms of stress.  Slow deep breathing exercises can help with feelings of anger or acute anxiety (panic attacks)

Catch yourself being too negative with yourself or others and ask yourself if that way of thinking or behaving is helpful

Do more exercise – it can make you feel more positive and energetic and gives you time out from your daily routine.

Coping with the normal stressors of life can make you feel in control and good about yourself.

  • Try to make positive changes to your lifestyle that act as a buffer against the effects of stress
  • Drink alcohol in moderation (21 units for men, 14 units for women/week) click here for more information 
  • Eat a balanced diet with regular meals to maintain your recommended weight, click here for more information 
  • Cut down on caffeine (coffee, tea and fizzy drinks) and drink plenty of water
  • Stop smoking, click here for more information 
  • Take regular exercise – aim to achieve at least 30 minutes on at least 5 days of the week, click here for more information  
  • Manage your time and be assertive
  • Develop an effective support system – having others to rely on is a significant factor in controlling stress
  • Seek professional help or information if you are unsure about any aspect of your heart condition and recovery
  • Monitor any negative thinking – could things be viewed differently?
  • Find more ways to relax and give yourself a treat

Changing your lifestyle in this way can make you feel physically fitter and better able to cope with stressful situations. 

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Do I need to go for professional help?

You may need further help if the information given here is not enough or symptoms of stress are regularly affecting your abilities to cope with your responsibilities or relationships.  You may also need help if you think you may have depression or if you use addictive substances regularly (e.g. alcohol, cigarettes, illegal drugs) to cope with stress or if you have any thoughts of self harm. Remember too much stress can affect anyone at any time of their life. Getting professional help can be a positive decision to help you look after yourself. 

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