Stress in any form can be unforgiving and exhausting. If it stems from a more severe and terrifying incident, causing post-traumatic stress disorder (PTSD) then it could even trigger serious cardiac complications including heart attacks.
What is PTSD?
Rtd Prof R Srinivasa Murthy of Psychiatry at the National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, says, there is an increased incidence of every type of illness in people with PTSD including heart problems. “In PTSD, the person remains in a hyper-vigilant state in fear of the disaster or the trauma occurring again. So, that heightened awareness being present all the time is not good,” he says.
Prof Murthy, formerly on the staff panel of the United Nations (UN) and World Health Organisation (WHO) cites examples of the 1984 Bhopal gas tragedy and 1999 Odisha super cyclone survivors to highlight this mental state.
Does PTSD cause heart problems?
Several studies show an association between PTSD and heart health. The study ”Association Between Posttraumatic Stress Disorder and Mortality Among Responders and Civilians Following the September 11, 2001, Disaster’ states that… the cardiovascular mortality risk was 72% higher among people with PTSD.
Kolkata-based Dr MK Das, representative (Asia), assembly of international governors of the American College of Cardiology (ACC) and president of the Asian Heart Society, says, “Trauma-induced stress causes secretion of catecholamines, responsible for the body’s fight-or-flight response. But its excess secretion during trauma can affect the heart. It can cause high heart rate, and acute arrhythmia (an irregular heartbeat), leading to atrial or ventricular fibrillation and tachycardias. Arrhythmias may cause sudden cardiac death too.”
Dr Das adds that stress disorders can affect the heart muscles too. Catecholamines can affect cardiac muscles like myocardium, leading to systolic dysfunction, the symptoms of which mimic a heart attack. “The dysfunction of the heart can lead to heart failure or takotsubo syndrome,” he says. It is also called broken heart syndrome.
Symptoms of PTSD
Dave, a 32-year-old former paramedic in Ontario, Canada, lost interest in his favourite activities and developed panic attacks. At first, he was not sure what was causing his irritability, anxiety, depression, nightmares and hypervigilance, which would elicit a flight or fight response from him for every sudden noise. He started skipping work and becoming paranoid about almost everything that was associated with his paramedic work.
Dave noticed that his alcohol intake too steadily increased. Now a gamer, he recounts his struggle on the professional and personal fronts until he was diagnosed with PTSD in November 2020.
“I was constantly checking my vitals at work. During panic attacks, my heart rate went as high as 160 but usually, it is around 100-120 beats per minute,” he says, adding that he now sometimes feels shortness of breath with exertion and is planning on doing a heart checkup soon, but mostly due to family history.
PTSD after a heart attack
Prof Murthy adds about 30 per cent of people with PTSD develop the chronic disorder, which can make any medical treatment more difficult. “Their immunity gets compromised. PTSD affects the vagal nerve, which touches the heart,” he says. Emergencies like heart attacks can also sometimes cause PTSD.
Dr Das says, “People have been often surprised to learn that they have high sugar levels after a heart attack. Heart attack can be a stressor, which can lead to diabetes.” It has been pointed out that the body’s internal response to a heart attack could lead to an increase in blood glucose levels post-heart attack.
PTSD and heart disease
Chronic stress can affect blood vessels too. Dr Das says secretion of catecholamine can cause arterial plaque formation and lead to coronary artery disease, angina or acute heart attack.
“Obstruction of blood flow can cause thickening of heart muscles, leading to ventricular hypertrophy (thickening of walls of left ventricles). It can also cause thinning of muscles, which lead to dilation of the heart chamber and then, ventricular diastolic dysfunction (inability of the heart to fill up with normal blood volume),” he says.
PTSD is also linked with obesity, hypertension, cholesterol and diabetes. It can also lead to depression, substance abuse and lack of sleep, which add to the risk of heart problems.
Takeaways
- Several studies show an association between PTSD and heart health.
- PTSD causes the secretion of catecholamines, which is responsible for the body’s fight-or-flight response, but it can take a toll on the heart.
- Excess secretion of catecholamines can lead to high heart rate, irregular heartbeat, heart attack and heart failure.
- PTSD can also cause obesity, hypertension, cholesterol, diabetes, depression, substance abuse and lack of sleep, which add to the risk of heart problems.
