Broken Heart Syndrome


 

We use the term 'broken heart' to describe someone suffering emotional distress, but not experiencing an actual medical condition. In cardiovascular medicine, however, this phrase is no longer strictly symbolic. Medical professionals now understand that there is a direct link between severe emotional and a serious cardiac condition.

Broken heart syndrome is a common name for stress-induced cardiomyopathy, a disease that affects the heart's muscle tissue. Symptoms of the condition are almost identical to those of a heart attack and may include sudden chest pain, shortness of breath and an irregular heartbeat.

While researchers have not yet determined a specific cause of broken heart syndrome, it is known that when stress hormones, such as adrenaline, surge into the heart, they trigger changes in muscle cells and blood vessels. Those changes prevent the left ventricle from properly contracting.

As cardiomyopathy worsens, the weakened heart becomes less able to pump blood or maintain a normal electrical rhythm. The result can be heart failure or arrhythmias and can include other complications, such as heart valve problems.

Diagnosing broken heart syndrome can be a challenge. "It looks like a heart attack," said UAB cardiologist Gregory Chapman, MD. "The only way to know that it's not one is through tests in a cath lab, where we can determine if the arteries are blocked. Once we see that the arteries are normal, but the left ventricle has ballooned out, we may diagnose stress-induced cardiomyopathy."

Chapman once suspected that a female patient who was in the ER for chest pains was experiencing the syndrome because the woman's daughter had just been killed in a plane crash. An examination confirmed that the patient had no blocked arteries, and an X-ray view showed her left ventricle had swollen.

Procedures that are often used to treat a heart attack, such as balloon angioplasty and stent placement, or even surgery, are not effective treatments for broken heart syndrome. Standard treatment involves the use of medications that manage the symptoms and effects of the cardiomyopathy. Initial recovery takes place with a hospital stay. Afterward, patients will take the same medications used to treat congestive heart failure to support and strengthen the heart. Most patients recover within 30 to 90 days.

People who have broken heart syndrome usually do not have any heart disease symptoms before they are diagnosed with the syndrome. More than 90 percent of reported cases are in women ages 58 to 75. Research suggests that up to five percent of women evaluated for a heart attack actually have this disorder, which can go unrecognized.

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