Experiencing emotional or physical stress causes an increase in heart rate, elevation of blood pressure, and release of stress hormones. All these result in a greater workload for the heart, which can be dangerous. Stress can cause a heart attack, sudden cardiac death, heart failure, or arrhythmias (abnormal heart rhythms) in persons who may not even know they have heart disease. Individuals with congestive heart failure, coronary heart disease, known arrhythmias, or other heart or blood vessel diseases should avoid emotional stress whenever possible and learn to manage the effects of stress. Excessive physical exertion and emotional stress may cause problems in both men and women, but women seem to be particularly susceptible to developing heart problems in the face of emotional stress. Ask your doctor about any limitations on physical activity or vigorous exercise if you have heart disease.