The details behind the hospitalization of Tiger Woods? mother-in-law are none of our business. But the news earlier this week that she had been rushed to the hospital has raised questions about whether, and how, a stressful situation might trigger the kind of problems that prompted Elin Nordegren to call 9-1-1 for her mother Barbro Holmberg.
It is common for stressful situations to produce stomach pain?which is what Elin?s mother reportedly suffered from?and, yes, that pain can be excruciating enough to take one?s breath away, says gastroenterologist Yehuda Ringel, of the University of North Carolina School of Medicine. Ringel?s research and clinical practice involves patients who feel debilitating gut pain with no apparent physical cause.
?A patient?s doctor may tell her it?s all in her head, but it is also very much in her gut,? Ringel says. A superhighway of nerves directly connects the brain and digestive tract, he explains. As a result, acute anxiety can produce a lightning bolt of stomach and intestinal pain. This pain may stem from increased gut sensitivity, spasms, or both.
Though anxiety-related stomach pain can result without any other underlying cause, anxiety can aggravate painful conditions such as acid reflux, peptic ulcer, and irritable bowel syndrome, Ringel says. In the case of acid reflux and peptic ulcer, the increased pain often stems from a sudden burst of gastric acid into the stomach.
Even more frightening, perhaps, is the pain that feels like a heart attack.
?An argument, intense anger or anxiety?we often hear from patients that something along these lines happened just before a heart attack,? says cardiologist Russell Luepker of the University of Minnesota?s School of Public Health. ?Such acute triggers seem to tip people over the edge if they already have narrowing of the arteries,? he explains.
Intense emotion, like intense exercise, causes the heart to pound harder and faster, increasing its need for oxygenated blood. If narrowed arteries prevent enough blood from getting through, you may feel the pain of angina. A complete blockage, as from a clot, escalates the problem into a full-blown heart attack.
Both angina and heart attack are typically felt as chest pain with shortness of breath. But occasionally they are felt as stomach, back, or even shoulder pain, Luepker says. (Such possibilities may explain why Elin?s mother was rushed to the hospital.) And some studies show that women are more likely to experience such atypical symptoms.
Angina will ease if a person calms down and rests. It?s not a medical emergency, but warrants a call to your doctor, Luepker says. If the pain doesn?t go away within 10 to 15 minutes, though, it may well be a heart attack. In that case, it makes sense to call 9-1-1.
That said, high anxiety alone can trigger all the symptoms of a heart attack, says clinical psychologist Barry Jacobs, a spokesperson for the American Heart Association and a director of behavioral science at Crozer-Keystone Health System near Philadelphia.
?A panic attack is a very severe form of anxiety that?s more than a mental state,? Jacobs explains. ?Its physical symptoms include muscle tightness so severe that it literally causes chest pain and shortness of breath.? Profuse sweating and nausea are also common. All these symptoms stem from the release of stress hormones such as cortisol. ?Unfortunately, when people interpret these symptoms in a catastrophic way and believe they?re dying, that makes them more anxious and produces worse symptoms,? Jacobs says.
As with angina, the pain of a panic attack or high anxiety will ease once a person is able to calm down. Understandably, that can prove difficult?particularly when the symptoms mirror those experienced during a heart attack.
Though it?s not clear that Elin?s mother was suffering stress-induced symptoms (she was released about 11 hours after she went to the hospital), doctors say Elin likely made the right call when she dialed 9-1-1. With lingering stomach pains or other symptoms that can indicate a heart attack, the experts agree it?s better to be safe than sorry.