Stress and heart disease

Flight attendants always remind passengers about this self-care rule:

“In the event of a sudden drop in cabin pressure, an oxygen mask will drop from above. Secure your mask first before assisting others.”

Shyleen Ram, 45, has been putting on oxygen masks and assisting others first for nearly 20 years—trying to take care of her two children (now young adults) as a single mom and dealing with expectations at work to earn an income and make ends meet.

She experienced the equivalent of a "drop in cabin pressure" on Jan. 3 when she had a heart attack. And stress was one of the contributing factors, agree Shyleen and her doctors at the Misericordia Community Hospital

Shyleen says being busy and making a lot of personal sacrifices became her normal way of life.

“Taking time for myself wasn’t an option. I was lucky if I could get six hours of sleep at night,” she says, adding the personal sacrifices she made were all in the name of giving her two children “the best start in life so that they can have a better life for themselves.” And she’s proud that her kids have stayed on the right path as they work to achieve their dreams as engineering students at the University of Alberta.

Shyleen notes that working for 16 years in sales, where the pressure to meet quotas is intense, added a layer of stress to her life, especially during the last few years when Alberta’s economy has been in a funk. She sells beauty products to salons and spas throughout Edmonton.

“Sales targets don’t get revised down even if people have decided to cut back on their hair and personal care spending,” she says. “My sales manager will be ‘yippin’ down at me if I don’t meet them,” she adds.

Shyleen Ram joined a cardiac rehab program to mend her heart. Stress was a major contributing factor to her heart attack.

“Studies have shown that patients with a history of anxiety may have increased incidence of cardiovascular disease. Chronic anxiety can put you in a state of stress, which increases inflammation of the heart and progression of plaque buildup. Chronic stress increases blood pressure and negative coping mechanisms such as overeating and low physical activity,” says Dr. Sayra Khandekar, Facility Chief of Cardiac Sciences (interim), Director of the Echocardiography Lab at the Misericordia Community Hospital and Associate Clinical Professor of Medicine at the University of Alberta.

“People who are working in high-stress jobs don’t necessarily realize that stress has a cumulative effect on the body,” says Sayra. “Women in high-stress jobs are at 40 per cent higher risk of having heart disease because they often have a bigger role at home and they juggle those things.”

Shyleen admits that she also smoked half a pack of cigarettes a day for a number of years prior to her heart attack as a way of coping with stress and anxiety.

Thinking that being in a constant state of stress was just a normal part of life, she ignored many of the physical ailments she felt early on. “I’d been taking Tums for a number of years to try to deal with my chest discomfort, which I attributed to heartburn. I also felt some shoulder pain, which I attributed to just being tired and needing a massage or putting on some heat to ease it,” she says.

Shyleen didn’t know at the time that she was already showing symptoms of cardiovascular disease. During her hospital stay at the Misericordia, doctors found two major clots with 80 per cent of the arteries blocked. They inserted stents and gave her medication to help her heart function normally, she says.       

Shyleen recently signed up for a cardiac rehab program at Glenrose Rehabilitation Hospital, where doctors and professionals will try to help mend her heart by giving her tools to deal with some of the underlying causes that contributed to her heart attack.

Sue Goulet, Nursing Educator at Misericordia Hospital, reminds people to always try to achieve work-life balance. “When work-life balance is off, try to get it back by taking care of yourself.

“Set some realistic goals. Don’t think you have to put on a supermom cape every morning and go to work and do everything,” Sue says. Taking time to “exercise will help with being able to think clearly and having lower blood pressure.”

Aside from taking the time for self-care and wellness activities, Shyleen wants to share other lessons she learned from the heart attack experience. Looking back, she wishes she knew about the early warning signs of heart disease. She also wishes she didn’t dismiss the chest discomfort, shoulder pain, insomnia, fatigue and other symptoms as just normal reactions to stress.

“Talk to your physician if you are experiencing these things. Try to make sure they are not early signs of heart disease,” she says.

Sayra notes cardiovascular disease is the number one killer for women each year. “It kills more women every year than all cancers combined.” The good news is that anyone can do something to modify their risk factors. “There is no downside to managing stress," she says. "It is a win if you take steps to lower your chances of heart disease."

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