A Broken Heart Mirrors Signs Of A Heart Attack Doctors Calls The Condition Broken Heart Syndrome

WATERBURY, Conn. — Doctors call it the broken heart syndrome. A patient suffering from severe emotional stress has all the signs of a conventional heart attack.  While rare, the syndrome, which is seen predominately in women, is brought on by severe emotional distress and physically alters the beating of a heart.  “It is, by every measure, a heart attack. Patients come to the emergency room with chest pain. They do have EKG changes. They do have evidence in their blood that the heart muscle has been injured,” said Paul Kelly, a cardiologist at St. Mary’s Hospital in Waterbury.  Kelly said when a patient found out that her mother had died 48 hours before her wedding, she was rushed to the hospital with what doctors thought was a heart attack.  The severe emotional distress the patient experienced caused a surge of adrenaline in her body.  “The heart is squeezing very vigorously from the front and on the underside. You can see it’s contracting. It’s almost super contracting, pushing very, very vigorously, “ Kelly said  Unlike a heart attack, the symptoms of a broken heart come on very rapidly, within minutes of hearing bad news, and go back to normal almost as fast.  Less than 1 percent of patients who go to the hospital with chest pains actually have broken heart syndrome, Kelly said.  Therapy for a broken heart syndrome are beta blockers, medication that can shield some of the adrenaline and give the heart a chance to recover. The heart usually recovers within two days, Kelly said..  Kelly said chocolate also mends a broken heart.  “Dark chocolate, and pounds of it,” he said.

What do you think?  Next time you run that call to a family member who is hysterical and complaining of chest pain, because they just found out another family member or friend has died, may actually have a real medical situation.

Other interesting facts about Broken Heart Syndrome.

About 70-80% of cases of Tako-tsubo Syndrome (TTS) occur in post-menopausal women under some form of extreme, exceptional and prolonged mental stress,… with no good way out, no relief and often feeling deep resentment (such as the loss of a dear one…)

(Note: a word of caution… , in a minority of patients (<20%) the stress is physical (such as massive trauma, surgery or severe pain, or other type of stress. In very rare cases, no “cause” can be found).

Tako-tsubo Cardiomyopathy or Syndrome is also known as:

• neurogenic myocardial stunning,
• stress cardiomyopathy
• stress-induced cardiomyopathy,
• transient left ventricular apical ballooning,
• “ampulla” cardiomyopathy
• “broken heart syndrome”.

“Tako-tsubo” is the japanese name for octopus traps that fishermen still use to catch octopus. In this syndrome, the heart (left ventricle) takes the shape of an octopus trap (tako-tsubo). How about that!

The shape that the left ventricle takes (tako-tsubo shape) is due to a state of complete exhaustion of the heart muscle (myocardial stunning) in the mid-section and tip of the heart. The fascinating part is that it occurs in patients without significant blockage (stenosis) of their coronary arteries (now: that is surprising and remarkable!).

A profound tako-tsubo syndrome is quite dangerous if not recognized as it can lead to transient but severe (occasionally lethal) cardiogenic shock. Electrocardiogram can show non-specific ST-T abnormalities, ST elevation, and/or QT prolongation with large negative T waves. Sometimes those changes occur in succession. And here is another surprise: the cardiac bio markers of heart damage (troponin, creatine kinase) are only very slightly elevated, confirming that there is not much heart muscle damage, but severe suffering (stunning) instead.

And that leads to the good news, Folks!
If this syndrome is recognized, over 95% of patients pull through that fairly easily (with most of the time complete recovery of the electrocardiographic changes and recovery of the cardiac shape and function. This may take a few weeks).

Suggestion: patients should be send to cardiac rehabilitation and if possible to a stress reduction clinic if the syndrome is complicated by continued stress or by a syndrome similar to “post-traumatic stress syndrome”.
The idea is to prevent recurrence (which is low but still exists) by indentifying and trying to eliminate or deflect stressors while educating patients how to counter and how to develop resilience to stress

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