Follow Your Heart: Live Well, Stress Less

By Dr Chong Jun Hua, Consultant, Cardiology

“Wah I very stress lah!” – How often do we hear this from people around us or even ourselves?

In a fast-paced society like Singapore, stress seems to be an inevitable part of life. Common stressors can include work¹, school², family responsibilities³ and finances⁴. These demands are part of everyday life, but they can trigger a stress response when we feel overwhelmed⁵ or when we begin to question if our efforts matter at all⁶. 

When a stress response is triggered, a person may experience various physical symptoms such as stomach problems, headaches, muscle pain, skin rashes, dizziness, nausea, and chest pains. These symptoms usually ease once the stress subsides⁷.

Stress can also affect emotions. A person may become irritable, angry, or tearful and may feel worried, hopeless or scared. Stress can also lead to racing thoughts and impair decision-making⁷.

Our stress reaction originally evolved as a survival mechanism known as the “fight-or-flight” response8. When faced with threats, our brain signals the body to prepare for action – giving us the energy to either confront the situation or escape. However, staying in a constant heightened state of “fight-or-flight” is not sustainable for the body. Chronic stress can push survival mechanisms into overdrive, leading to possible health problems such as hypertension, depression, anxiety and poor sleep. To cope with the ongoing stress, some people may turn to smoking or comfort eating, while others may lose the motivation to exercise. Over time, these unhealthy coping behaviours can lead to additional health risks⁹.

How Stress Affects the Heart

While stress affects the whole body, the heart is particularly vulnerable. Ongoing stress has become known as a major cause of heart disease on its own¹⁰. Chronic stress triggers harmful changes in our body that affect our hormones, nerves, immune system, and other vital functions. This leads to weight gain, hypertension, diabetes, atherosclerosis (cholesterol blockage of blood vessels) and increased inflammation in the body¹¹.

At its extreme, stress can lead to “broken heart syndrome” (stress cardiomyopathy or Takotsubo cardiomyopathy)¹². Stressful situations, extreme emotions and serious physical illness or surgery can trigger a surge of stress hormones such as adrenaline. People with broken heart syndrome may develop sudden chest pain and believe they are having a heart attack. This condition is more common in women, older adults, and those with pre-existing mental health conditions. While most people make a full recovery from broken heart syndrome, some individuals may have lasting heart issues.

REFERENCES

1. 1 in 3 S’pore workers reported facing work-related stress or burnout: Data from MOM online tool, The Straits Times, 25th Sept 2025.
2. Regardless Of Grades: Why Are Singaporeans So Obsessed With PSLE?, CNA Insider (YouTube), 29th March 2024.
3. Household and care responsibilities a source of stress for more than half of mums: Study, The Straits Times, 6th May 2021.
4. Close to half of Singapore residents say they will never achieve financial freedom: Poll, The Straits Times, 26th August 2024.
5. 10 stress busters - NHS, United Kingdom, 9th September 2022.
6. Schnell, T., Krampe, H. Meaningfulness protects from and crisis of meaning exacerbates general mental distress longitudinally. BMC Psychiatry 22, 285 (2022). https://doi.org/10.1186/s12888-022-03921-3
7. Stress: What It Is, Symptoms, Management & Prevention – Cleveland Clinic, 15th May 2024.
8. What Is the Fight, Flight, Freeze or Fawn Response? – Cleveland Clinic, 22nd July 2024.
9. Stress and Heart Health | American Heart Association, 8th February 2024.
10. Stress may be your heart's worst enemy, The Straits Times, 12th January 2022.
11. Osborne MT, Shin LM, Mehta NN, Pitman RK, Fayad ZA, Tawakol A. Disentangling the Links Between Psychosocial Stress and Cardiovascular Disease. Circ Cardiovasc Imaging. 2020 Aug;13(8):e010931.
12. Takotsubo cardiomyopathy (broken-heart syndrome) - Harvard Health, 13th June 2023.
13. Blumenthal JA, Sherwood A, Smith PJ, Watkins L, Mabe S, Kraus WE, Ingle K, Miller P, Hinderliter A. Enhancing Cardiac Rehabilitation With Stress Management Training: A Randomized, Clinical Efficacy Trial. Circulation. 2016 Apr 5;133(14):1341-50.