Can stress cause a heart attack?

Probably: In someone with undelying coronary artery disease. This is an area of research as to what factors contribute to an unstable plaque which is a precursor to a heart attack, stress is certainly one factor.

Yes: Atherosclerosis, the underlying setup for heart attacks, typically starting in childhood yet asymptomatic for decades: the artery walls thicken & enlarge at the plaque locations, thus no narrowing of the lumens carrying blood. If the endothelial covering of a plaque is thin, then anything that increases pulse pressure (artery stretching), e.g. Exercise or anger, can induce plaque rupture & damage.

Stress & Heart Attac: Stress over time increases your cortisol which increase your blood sugar, which contributes to insulin resistance in many cases, which causes inflammation, which is what causes heart attacks and strokes. In the short term, big stress can raise blood pressure and pulse and stress your heart, which can cause a heart attack in the right setting. Stress management is important.