UNDERSTANDING THE IMPACT OF STRESS ON THE BODY

Many of us have to live with constant worry about our own health, our loved ones’ health, and our jobs. That’s on top of adapting to a lot of change. It’s an understatement to say this can be a bit stressful.

In addition to the mental toll that stress can have, there are also physical effects of chronic stress. Generally, our body can handle stress in small doses. When that stress becomes long term, it can affect all systems of the body, such as muscles, the cardiovascular system, and the gastrointestinal system to name a few.

WHAT ARE THE PHYSICAL EFFECTS OF STRESS?

Stress can cause muscles to tense up. With chronic stress the muscles are taut and tense for long periods of time. This may cause a number of conditions, such as tension headaches, migraines, and low back pain.

Within the cardiovascular system, an increased heart rate and elevated stress hormones and blood pressure are common responses to stress. It may also contribute to inflammation in the coronary arteries. Dealing with chronic stress can mean experiencing these symptoms for a prolonged period of time. This increases the risk of hypertension, heart attack, or stroke.

This is of particular concern for older women. When estrogen levels drop during menopause, women have an increased risk of heart disease and chronic stress can add to this risk.

Chronic stress can also affect the gastrointestinal system. Dealing with stress can alter your eating patterns, you might eat more or less than usual, or change the types of food you eat. These changes may disagree with you and lead to pain, bloating, nausea, and stomach discomfort. It can also affect how food moves through the bowel and cause diarrhea or constipation.

Long periods of stress can take a toll. Chronic stress has been linked to chronic fatigue, diabetes, obesity, depression, and more.

MANAGING STRESS

The Canadian Mental Health Association recommends a number of tactics to manage stress:

• Identify the problem and talk about it.
• Develop strategies for dealing with stress.
• Get active – physical activity can help reduce stress and improve your mood.

There are numerous national support programs, as well as local Alberta and Saskatchewan programs, which can help you cope with stress. It’s also important to speak with your health care practitioner about both your mental and physical health. Your doctor can refer you for mental health supports, as well as investigate any physical symptoms.

For example, your doctor may request an abdominal ultrasound to investigate abdominal pain or intra-abdominal structures, or a musculoskeletal ultrasound to investigate muscle pain. For cardiovascular concerns such as chest pain, medical imaging can assess the heart function, electrical changes, or blood flow (exercise stress testing, myocardial perfusion imaging). Coronary computed tomography angiography (CCTA) may also be appropriate.

CCTA can non-invasively examine the coronary arteries using a combination of X-rays and computer technology to produce comprehensive, detailed images. It’s designed to look for plaque buildup in the arteries supplying the heart muscle (a risk factor for heart disease). Patients with family histories of heart disease may be at risk for developing atherosclerotic plaque buildup, blocking or narrowing these arteries. On CT, these can be identified even before symptoms of chest pain develop.

SYMPTOMS TO BE AWARE OF

Speaking to your health care practitioner about any mental or physical concerns helps manage stress and can help to address symptoms early, before they become troublesome. In particular, it’s important to be aware of any symptoms that may be a sign of heart problems.

In both men and women, the most common sign of a heart attack is chest pain or discomfort, but you can experience a heart attack without chest pain or pressure. Here are some important warning signs to be aware of:

1. Chest discomfort – is the most common sign and can be described as pain, tightness, or pressure in your chest. It may be a sign of a blocked artery or heart attack.
2. Nausea, indigestion, heartburn, or stomach pain – the nerves in your gastrointestinal tract are closely intertwined with the nerves from the heart, so heart pain can feel like stomach pain. Usually, nausea caused by an impeding heart attack gets worse with physical exertion and eases with rest.
3. Radiating pain – this is also a common symptom. Pain may spread down the left side of the body or upwards to your throat or jaw, or be solely centered in the arm. Women may also experience upper back pressure.
4. Dizziness or light-headedness – this can be caused by many factors, but if it’s combined with chest discomfort or shortness of breath, call a doctor. It could mean your blood pressure has dropped because your heart isn’t pumping properly.
5. Shortness of breath – panting or difficulty drawing deep breaths could be a sign of a heart attack.
6. Sweating – if you break out in a cold sweat for no obvious reason, this could be a sign of a heart attack.
7. Irregular heartbeat – it’s normal for the heart to race during periods of tension or excitement, but, if you feel this happening for more than just a few seconds or regularly, it could signal atrial fibrillation and require treatment.
8. Extreme fatigue – you should pay attention if your usual routine seems unusually hard, or you wake up still feeling tired. It can signal weakness of the left ventricle, the main muscle responsible for pumping blood from the heart to the rest of the body. (Women more often report experiencing this symptom than men, but men may also experience it in the days leading up to an attack.)

If you experience any of the above emergency signs, it’s important to call 9-1-1 for the fastest medical help. For more information, please visit the heart and stroke website.

REFERENCES

American Psychological Association (2018) “Stress effects on the body.” www.apa.org. Accessed March 11, 2021.

Canadian Mental Health Association (2016) “Stress.” www.cmha.ca. Accessed March 9, 2021.

Heart and Stroke Foundation of Canada. (2021) “Emergency signs: When to call 9-1-1.” www.heartandstroke.ca. Accessed March 9, 2021.

Mayo Clinic Staff (2017) “Heart attack symptoms: Know what’s a medical emergency.” www.mayoclinic.org. Accessed March 9, 2021.

Newby, D. E., et al. (2018) “Coronary CT Angiography and 5-Year Risk of Myocardial Infarction.” The New England Journal of Medicine, 2018; 379: 924-33.

Pietrangelo, A. (2020) “The Effects of Stress on Your Body.” www.healthline.com. Accessed March 9, 2021.