Can coronary spasms caused by stress? cause a heart attack?

Yes: Some folks have coronary arteries that are particularly spasmotic which can lead to poor blood flow to the heart (a heart attack) - also known as prinzmetal's angina. Fortunately, this is rare. Emotional stress can also cause a cardiomyopathy - known as takotsubo, which is not a heart attack per sey but can lead to many of the same symptoms.That aside, stress = high BP = increased risk of attack.