Dr. C. Noel Bairey Merz, professor of medicine and medical director of the Barbra Streisand Women's Heart Center at the Cedars-Sinai Heart Institute and colleagues found emotional stressors -- such as those provoking anger -- might cause changes in the nervous system. These changes in what controls the heart rate also trigger a type of coronary artery dysfunction that occurs more frequently in women than men.
In men with coronary artery disease, the large arteries feeding the heart tend to become clogged by plaque, and these blockages are evident on coronary angiograms, she said.
However, women might have chest pain related to the heart being starved for oxygen, but have no evidence of arterial obstruction.
"Women who go to emergency rooms and cardiologists because they have chest pain often are told that their arteries are clear and their hearts are fine. But the reality is that women's coronary artery disease tends to be different from men's," Bairey Merz said in a statement.
"In women, the large arteries may remain clear but the smaller branches that connect to the even-smaller capillaries lose their ability to widen. Whether the large arteries are blocked or the small arterioles don't function correctly, the result is the same -- the heart becomes starved for oxygen."
The findings were presented at the American Psychosomatic Society's annual meeting in San Francisco.