Can you really be scared to death?

The Halloween season means trick-or-treaters in costumes, haunted houses, corn mazes and an assortment of scary movies. These “spooky season” staples often evoke feelings of excitement or fear – and can prompt the common expression, “You almost gave me a heart attack!”

But can you actually be scared to death?

“A heart attack can happen in certain individuals,” says Dr. Moe Zafarani, a cardiologist at Aurora Health Care. “It’s similar to the concept of patients who have preexisting heart conditions on roller coaster rides; that’s why you see signs that say it may not be appropriate for cardiac patients.”

When an individual experiences fear, there is a surge of stress hormones, including adrenaline and cortisol, that can cause cellular-level damage. One of the main heart complications that can occur when you experience fear is a faster heart rate, which can limit diastole.

“Diastole is the phase of the cardiac cycle where your heart is receiving fresh oxygenated blood,” Dr. Zafarnai says. “When you reduce diastole for prolonged periods, you may in effect reduce the flow of oxygenated blood to your heart. In a healthy person, this is not an issue as our hearts are designed to be robust; in a patient with coronary artery disease, this can cause chest pain and potentially cellular level damage.”

Another complication of decreased blood flow to the heart is vasospasm, a phenomenon where your arteries collapse momentarily, interfering with the delivery of oxygenated blood to your heart muscles.

“A combination of reduced diastolic filling and vasospasm can potentially cause stress-induced cardiomyopathy, which is better known as broken heart syndrome,” he says.

If you are experiencing fear or can feel your heart racing, Dr. Zafarani recommends these steps:

• Take a break and remove yourself from the environment that is causing this fear.
• Have a glass of water.
• Practice “belly breathing” — deep breaths through the nose and out through the mouth.
• Be prepared. Proper anticipation of “scary events” can minimize the consequences.

“If you have had a prior heart attack or you’ve been told to have a ‘weak’ heart, it might be best to limit your exposure to situations that may incite fear and anxiety,” Dr. Zafarani says.

Want to learn more about your risk for heart disease? Take a free online quiz.