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Stress causes the release of stress hormones. Over a long period of time, those hormones are destructive. They make blood platelets sticky. Sticky platelets cause clots to form in the heart arteries.

Answer: Stress is a factor in some heart attacks. For most heart attacks, many factors are found. Your husband tried to lead a healthy life. He did many things that are supposed to protect a person from heart attacks. Things you did not mention were his cholesterol and blood pressure. If both were normal, then stress is a reasonable answer.

Clots block the flow of blood to the heart. Blood carries oxygen to the cells. Cells die without oxygen. Dead cells mean a damaged heart. Over 90% of heart attacks are caused by a blood clot.

Dear Doctor: At age 43 my husband had a heart attack. No one in his family has had one. His father is alive and active at age 83. My husband was a faithful jogger and a nonsmoker. He ate healthy foods. How could he have had a heart attack? Could it be stress? He worked 80 hours a week.