Stephen Sinatra

Stephen T Sinatra M.D., F.A.C.C.

Heart Health

Anger and Your Heart

Watch Your Anger. Spare Your Heart.

Posted Aug 18, 2008

To me, anger is like the Achilles heel of the cardiovascular system, a trigger for serious problems, including a heart attack. Your blood vessels constrict and your blood pressure rises. The electrical currents to your heart become unstable. If you have arterial plaque, anger is like throwing a match into a can of gasoline. The plaque can rupture and the resulting clots kill you. Anger can also affect your ability to heal normally after surgery.

Two patient stories demonstrate the potential impact of anger.

Patient No. 1 was an attorney who had his new car scratched from one end to another by a teenage punk with a key. When he first saw the damage, the man got so angry that he had a heart attack on the spot. He was still livid when I saw him later in the emergency room. I had to calm him down and remind him that his car wasn't worth the price of his life.

Patient No. 2 was a Korean War veteran. He had bypass surgery and it so happened that when he opened his eyes after the operation he saw an Oriental face in front of him. One of his surgeons was a Chinese doctor. The reality of a Chinese doctor infuriated the patient, who still harbored vivid memories, twenty-five years after the war, of fighting the North Koreans and their Chinese allies. The resentment and emotions were so intense that they affected his healing. It took nine months for the chest incision from the operation to heal. Normally it takes a month. I worked with him psychotherapeutically for months to defuse his anger. His eventual physical healing depended on his emotional healing.

After I became a cardiologist I studied psychotherapy because of my interest in the mind/body connection. I always ask my heart patients about their emotions prior to an angina episode or heart attack. Many have said they had an outburst of anger prior to the event.

Although he wasn't a patient of mine, I will never forget the conversation I had with a cardiologist who was a top official of the American Heart Association. He told me that the thing that aggravated his own angina problem the most was anytime he got into a heated argument with his teenage son.

In the 1990s, Murray Mittelman, M.D., of the Institute for Prevention of Cardiovascular Diseases at Harvard, conducted a series of studies on anger and its effect on the heart. His research identified anger as a common trigger of heart attack and life-threatening arrhythmias. "The scope of the problem is sizeable-at least 36,000 (2.4% of 1.5 million) heart attacks are precipitated annually in the U.S. by anger," he said at the time.

Here's the moral of this short mind body story and a tip I tell my heart patients all the time. The minute you get angry over something the immediate thing that should come into your mind is this: Is this upset or argument worth dying for?

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