Monday, 18 April 2016
Broken Heart Syndrome: A Real Killer
We've all heard tragic stories of elderly, long married couples who, when one spouse dies, the other "heartbroken" spouse dies soon after. But it's not just a sentimental idea—in fact, it is a real cardiovascular condition, new research shows.
A recent study published in the British Medical Journal (BMJ) revealed that the death of a partner is linked to a heightened risk of developing an irregular heartbeat (also known as atrial fibrillation) for up to a year afterward. This increases the risk of heart attack and heart failure.
Statistics showed that the bereaved partner had a 41 percent higher incidence of atrial fibrillation than those who hadn't experienced a loss and was greater when the death was unexpected.
But can you actually die from a broken heart?
"Definitely. There is a real disease called broken heart syndrome," notes North Carolina-based cardiologist Dr. Kevin Campbell.
"There is a heart-brain connection during acute stress such as death of a loved one that plays a role in this unusual but very tangible health threat."
About 6,230 people in the U.S. were hospitalized with broken heart syndrome in 2012, according to a recent study. Patients usually heal within a few days but complications can occur as well as fatalities, Campbell tells Newsmax Health.
The syndrome was first discovered by Japanese researchers 25 years ago. They named the condition Takotsubo's cardiomyopathy. Takotstubo is a Japanese term which means "octopus trap," a reference to the ballooning shape of the heart during an attack that resembles the trap used by fishermen.
"You can also refer to this as stress-induced cardiomyopathy," Campbell explains. "This disease actually mimics the symptoms of a real heart attack. Researchers have long established a connection between mental health, anxiety, depression, emotional stress and heart disease."
Campbell notes that when we are under extreme stress, our bodies naturally release stress hormones such as adrenaline, norepinephrine and cortisol into the blood stream. These hormones were important for the survival of early man, initiating the "fight or flight" response by stimulating the nervous system. In response to stress hormones, our heart rate increases, our breathing increases, and blood is sent to the skeletal muscles in preparation for battle.
But in modern times, that mechanism places enormous stress on the heart that can be life threatening.
"When the body releases large amounts of stress hormones at times of extreme stress in our lives, patients with Takotsubo's experience crushing chest pain, shortness of breath and can experience changes in their heart rhythm, blood pressure and blood chemistry that are identical to those seen in the setting of a heart attack," says Campbell. "However those patients do not have the traditional blockages in the coronary arteries that are known to cause heart attacks."
But the heart does begin to pump poorly for a period of time. More women than men are affected. In fact, says Campbell, 90 percent of reported cases have been female and vast majority of these women have been post-menopausal.
Dr. Tracy Stevens, a cardiologist specializing in women's heart health and spokesperson for the American Heart Association, tells Newsmax Health that while we don't know the exact reason why women fall victim to the syndrome more often than men, it may have a hormonal component.
"Women have estrogen in their heart and blood vessels and may process adrenalin differently than men," she says. "Women handle stress differently too. When men sit down and relax, their heart rate lowers and they truly relax. When women sit down, their minds are still going on that hamster wheel and their pulse doesn't lower in the same way as men."
While victims of broken heart syndrome usually recover quickly, there can be complications.
"During the acute phase of the syndrome, the heart can be severely weakened and patients may suffer congestive heart failure requiring emergency surgery and hospitalization," says Campbell.
Dr. Steven Masley, a noted physician, author and fellow with the American Heart Association, tells Newsmax Health that broken heart syndrome is typically brought on by stressful situations, there may be other causes.
"Some medications can cause symptoms as well, such as the injection with an Epi pen or taking an excessive dosage of thyroid medication," says the Florida-based expert and president of Masley Optimum Health Center.
Campbell adds that both good and bad extreme life stressors can trigger an episode. He says that the diagnosis is made by performing an angiogram along with taking a heart ultrasound called an echocardiogram.
"In cases of broken heart syndrome, the heart arteries appear normal but the pumping chamber is often dilated and appears to be in the shape of a fishing pot used for catching octopus in Japan called the Takotstubo—hence the name."
The treatment usually involves medicine such as beta-blockers and ACE inhibitors that are given initially to help the heart pump more efficiently and promote remodeling of the heart muscle.
"Other medicine, such as diuretics, are given to help remove the excess fluid from the lungs and other parts of the body that collect due to the weakness of the heart," says Campbell. "In extreme cases where the patient develops cardiogenic shock, where the heart can't pump enough blood to the body, other interventions may necessary.
"For most, however, complete recovery is expected in days to weeks as opposed to a true heart attack, where recovery can take much longer."
New research based on a recent study conducted at New York University Langone Medical Center, is looking into preventative measures using yoga, breathing and other relaxation techniques to calm down the body's parasympathetic nervous system to avoid an episode of broken heart syndrome.
"In theory, that makes a lot of sense," says Stevens. "If we learn to deal with stress without raising our heart rates and blood pressure, we can possibly avoid broken heart syndrome."
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