Surprising Heart Attack Triggers

Know the facts about what can trigger a heart attack

question marks in shape of a heart

The best way to manage heart health is through diet and exercise and, when necessary, the use of prescription medications. But there are certain heart attack triggers that might surprise you. In general, we think of the four “Es” as follows: exertion, exposure to cold, emotion and eating.

Too much exertion, too quickly

Over exertion

We all know that a regular exercise program is good for us, but it is important to work up to a level of fitness and not just “jump in.” If you are not used to regular aerobic exercise, sudden and strenuous physical exertion can lead to a heart attack. This can include everything from playing a competitive game of basketball with friends to going hunting and carrying an animal. Too much exertion could also come from sex with a new partner/sexual activity, running or shoveling snow.

“You should avoid being over strenuous in activities such as these if you are not used to exercising, have cardiac risk factors such as a family history of heart disease, diabetes, high cholesterol or high blood pressure, for starters. Testing your ability to exercise, especially in weather extremes, can be a dangerous proposition,” says Curtis Rimmerman, MD, of Cardiovascular Medicine at Cleveland Clinic.

Cold temperatures

Senior Shovelling Snow

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Cold temperatures add to an increased risk for heart attack because they cause the arteries to constrict, which can cause a sudden increase in blood pressure. Combine this with physical exertion and the effects could be dangerous.

Dr. Rimmerman says people need to remember that shoveling snow is hard work and puts extra strain on your heart. Each year, shoveling snow sends more than 11,000 people to the hospital. While most have orthopedic injuries, 7 percent have cardiac problems, and many of these are heart attacks.

Intense emotions

Control Your Emotions

It turns out that extreme emotions, both good and bad, can have an impact on the electrical impulses of the heart. Studies show that the stress spanning extreme happiness to acute grief has the ability to spur a heart attack. This is due to the body’s involuntary and sudden increase in heart rate and blood pressure brought on by a surprising event.

Recent studies of grief have shown that the risk for heart attack is greatest within the first 24 hours of losing a close loved one and can remain high for a month after the person’s death. And sharp anger is another emotion with real consequences for the heart. In a 36-year study at John’s Hopkins, it was discovered that men who are quick to anger are more likely to develop premature heart disease and five times more likely to have an early heart attack.

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Eating a big meal


Studies have shown that a heavy meal can trigger a heart attack within a 26 hour period following the meal. The recent death of actor James Gandolfini from a heart attack brought this topic to the public domain. Researchers believe that this could be because eating raises levels of the hormone norepinephrine, which can increase blood pressure and heart rate.

Studies show other triggers for people with compromised heart function include excessive drug and alcohol use, too much caffeine and severe air pollution.

Knowing that these and other events can lead to heart attack just points out how important it is to keep your heart as healthy as possible with a carefully selected diet, regular exercise and medications, when necessary.

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  • Anthony Quinn

    What’s “suprising” about any of those triggers, Mr/Ms. headline writer?

    • Ignacio Martinez

      I’m sorry to tell you Mr Quinn but, not everybody is a genius and knows those facts. I’m an electronic and computer Engineer President of an international Electronics corporation and didn’t know that and I’m happy to know there are good professionals that worry about others. Thank you Mr/Ms. headline writer.

    • HeartBreaker

      What’s surprising is you lack of spelling

  • Brian

    Surely adding 6 gm per day of L-arginine to the diet would ward off all / most of such deaths!

  • Richard Kovacs

    The article clearly states they MIGHT surprise you. I didn’t know about big meals being a trigger since I wasn’t a Gandolfini follower. Other readers may be surprised about other triggers. The title properly assumes that not all readers are as well informed as Dr. Anthony Quinn, Medicine Man.

    • Ann Darnell

      Smart aleck

      • Richard Kovacs

        Looks like Dr. Quinn also performs as Ms. Darnell.

  • mike

    what a jerk know it all. Dr Anthony Quinn, medicine man for the Imadumass tribe. I found the article informative and a great reminder of certain dangers. Thank you

  • Meghann

    I think this was a great reminder for everyone, medically educated or not. Thank you author for this valuable and lifesaving reminder!

  • Construe_dat

    Good information, I wonder how many people have heart attacks in China during episodes of severe pollution. That could be titled, China Study II.

  • Sigmundine

    But interestingly many people die of a heart attack in their sleep in the early morning hours. Food has been digested and there has been no immediate heavy workout. You’re all cozy under the blankets, and presumably not terribly stressed out. I have often wondered about this.

    • The_Beating_Edge_Team

      There are theories about heart attack in early morning. First, a condition called sleep apnea increases risk for heart attack, arrhythmias, high blood pressure, blood clotting and stroke. So, people with this condition, over time, would be more likely to have a heart attack. Second, some studies have shown that more heart attacks occur during early morning hours on Mondays – the authors hypothesize there may be stress and high blood pressure related to return to work and increased blood pressure and arrhythmias related to binge drinking on the weekends. Last, small studies have shown that your circadian rhythm may be linked to a protein found in the blood. This level is lowest during the morning hours, which makes your heart more susceptible to heart arrhythmias and sudden cardiac death. betsyRN

      • Sigmundine

        Thanks so much, BetsyRN –

      • missingdave

        Lost my husband to SCD early on a Monday morning:-( no HTN or known heart probs but it was discovered that he had an enlarged heart.

        • The_Beating_Edge_Team

          I am so sorry to hear of your loss. thank you for sharing your story. betsyRN

  • Gretchen Hill

    This is just a reminders for all of us. According to the World Health Organization (WHO), nearly 17 million people around the world die of heart disease on a yearly basis. (Source:PlacidWay). So, we should be aware of the risk factors that may contribute to heart failure or other cardiac issues.

  • lee

    Is there an app for android phones to help monitor your heart.

    • The_Beating_Edge_Team

      Lee – I spoke to our Cardiac Rehab program and they said the following: There are many apps out there for smartphones, reviews highlight
      both pros and cons from those that have used the apps. To monitor for real time heart rate especially with activity, it is preferable to look into devices such as Polar or Omron heart rate monitors. Apps typically are
      free or low cost, for the higher quality items mentioned above, there will be cost associated.

      Hope this helps. By the way – you can always check your pulse! betsyRN

    • bellefolly

      If you have Cigna Insurance, there is an app that monitors BPM and Oxygen Saturation.

    • gail

      How good does it work?

  • Joe Giammarinaro

    This was very helpful. I was diagnosed with Hypertrophic Cardiomyopathy in 2012. I have found that emotional stories causes my heart to flutter a bit. I just have to find a way to minimize this. Thanks.

    • Marti Cozza Arnold

      First of all.. my best friend all through my life was a Iammarino. Paisana. Now. how in the world does anyone minimize stress? I’ve never found the secret.

  • Tony Pagano

    All very good observations regarding prevention and cause /statistics. I often wonder that since heart attacks do indeed most often occur in the AM, is it your sleep position relevant to your hearts “labor” that may cause blood flow to to curtail thus clot? And, like I do routinely, is taking an aspirin (325) before bedtime a real prevention? Last, will the body become immune to an an aspirins effect over time rendering this treatment useless?

    • The_Beating_Edge_Team

      I asked Dr. Gillinov, author of Heart 411, your question and he stated: “The precise reason that heart attacks are more common in the morning is unknown. It may relate to relative dehydration, which increases the thickness/viscosity of blood. It may also relate to changes in blood pressure and hormonal tone.
      You will not become immune to aspirin over time. But aspirin treatment for heart attack prevention should be used only in people who have arterial disease/blockages or those at high risk of such blockages (e.g. people with diabetes and other risk factors).” Hope this helps! betsyRN

  • shenpen

    Sigmundine , My theory on early morning hours is just like being on an airplane we are in bed for eight hours or more so the blood pools like when your on a plane but seems like Doctors don’t see that as why we have them in the mornings just my thought .

  • Brenda Fowler

    What about people who have panic attacks with high heart rates? I’ve had them for 28 years and I haven’t died yet. Heart rate goes to 160 and pounds like a jackhammer. My cardiologist says they can’t kill me. What about people who have svt? This doesn’t make sense.

    • The_Beating_Edge_Team

      Brenda – there have been studies that has shown that intense stress or emotion is a risk factor for heart attack. It may not be a run of SVT but if you are having SVT all the time or high heart rates all the time, then it will over time, cause your heart to work harder and possibly cause problems. If you are having an increase in panic attacks with high heart rates (they occur more frequently or last longer) – or you have longer runs of SVT that what is currently documented – then you should talk to your doctor about ways to control this either with medications or even non-medical biofeedback methods to get this under control. Let us know if we can help. betsyRN

      • Brenda Fowler

        I’m scared because no one has been able to fix my panic attacks. I’m suppose to be on a beta blocker but I have low blood pressure. I also have systemic lupus. Maybe I should just go on the beta blockers slowly. I’m afraid of taking medication but I’m more afraid of my pvc’s, svt and panic disorder. I don’t want to die of a heart attack.

        • The_Beating_Edge_Team

          Brenda – you may want to think about seeing someone who works with a team approach. For example in our Electrophysiology area, we work with a psychologist who works with anxiety along with our doctors. You may need to approach this in a couple ways to allow the least amt of medications to work the best. See the services of relaxation training – along – with treatment for your fast heart rate. You should discuss your options with your doctor. Hope this helps. betsyRN

          • Brenda Fowler

            Thank you for your advice. I want to live again and feel like I am part of this world.

  • Greg

    Is it safe for a person who has a pacemaker defribulator to ride @ an amusement park?

    • The_Beating_Edge_Team

      Greg – this depends on more than just having a device. You should talk to your doctor. It may depend on how high your heart rate goes up with excitement; your settings; as well as where the ICD is inserted. Please contact your doctor or the device clinic that is monitoring you. If it is at Cleveland Clinic, let us know and we can find you the answer. betsyRN

  • Shirley

    I believe people who live alone and have pets can have an heart attack from grief caused by the death of their pet.

    • The_Beating_Edge_Team

      Shirley – I can see your point. Loss and grief are triggers for heart attack. betsyRN

  • Sylvia

    I have sleep apnea and controlled blood pressure and high cholesterol. I stopped breathing 27 times in an hour. I also had my oxygen drop into the 60,s.
    I have problems using the machine. In the morning my nose ran and dripped until lunch. I had to keep a tissue in my hand all morning. It was so annoying that I stopped using the machine. My pressure is good however I have had my pulse as high as 112. I woke up with my heartbeat racing.

  • B C Walker

    Doctors & weather forecasters belong in the same category …. they make “educated” guesses, but do not truly know anything for certain.

  • Amanda

    Exactly why I turned the channel when the POTUS opens his mouth.