Broken Heart: A Real Disease?

In short, absolutely. Scared? You probably should be. Just when you thought you needed another reason to be careful in today’s dating environment. There is an actual “broken heart syndrome” called Takotsubo cardiomyopathy (or heart muscle failure) that is far more common in women and is an actual medical syndrome well described in the medical literature and recognized by the American Heart Association. “Takotsubo” is the Japanese word for a type of jar used to trap octopus, and is has a shape similar to the heart with this syndrome, which leads to a balloon-like, bloated shape as opposed to its normal configuration.

Having a broken heart releases a myriad of hormones that are part of any stress response, and if these hormones are released in very significant amounts it can cause damage to the heart muscle, eliciting acute heart failure, causing the heart to distend, pump inefficiently, and lead to cardiovascular collapse, including death

There is an obvious gender inequality to the occurrence of this syndrome, with the overwhelming majority being relatively healthy, adult women with no other cardiovascular problems. In over 90% of cases, it is precipitated by a period of extreme stress, such as divorce, death of a loved one, pregnancy, or other emotional stressors.  In order to be diagnosed with this syndrome, other causes of heart failure must be ruled out prior, but more and more we are recognizing it is a real, and not so uncommon phenomenon.

Most patients present to the emergency room because they are worried about a heart attack, experiencing the same symptoms such as chest pain, irregular heart rate, and dizziness. They are treated accordingly, but further investigation typically reveals no other cardiovascular issues such as blood vessel disease in a healthy younger patient, leading to the diagnosis of “broken heart syndrome”.

Without treatment, abnormal heart rhythms, stroke, and even death can result, but in the majority of cases, with appropriate management, hospitalization, and treatment, the syndrome resolves over days to weeks. Some are not so lucky. In fact, when I was in training as a cardiovascular surgery fellow, we implanted a temporary support “mechanical heart” in a woman that suffered from this syndrome due to severe problems during her delivery. She recovered about a week later allowing us to remove the devices, and thankfully did well, but did require major invasive surgery to sustain life, and in a poorly equipped center she may not have been so lucky.

What’s should we do? Protect your heart, in more ways than just exercise, and ensure that you have stress management tactics as a part of your daily routine.

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