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New insights into broken heart syndrome

April 15, 2014

It’s an age-old saying that someone ‘died of a broken heart’. Most people have heard reports of a couple married for 60+ years who die within a short time of each other, the second succumbing to a broken heart after the loss of their loved one. Today, research is exploring broken heart syndrome and confirms it is a real and genuine phenomenon. Dr Alexander Lyon, Cardiologist at The Physicians’ Clinic has a specialist interest in Takotsubo cardiomyopathy, as its termed in the medical world.

Dr Lyon is leading a major research strategy, including national UK and pan-European initiatives that will further our understanding of the biology of this condition and how the heart responds to stress and adrenaline rushes. Here Dr Lyon reviews a new study by medical researchers in the USA, presented earlier this month at a meeting for American cardiologists.

Broken heart syndrome and natural disasters

As scientists have found out more about broken heart syndrome, they have realised it does not only happen after a bereavement. It is also linked to the trauma people experienced when they are caught in the aftermath of a major disaster. The US study used data from a hospital database that charted hospital discharges across the entire country in 2011, looking for confirmed cases of Takotsubo cardiomyopathy.

They looked at the numbers occurring by state and discovered that two, Missouri and Vermont, had more cases of broken heart syndrome that year than anywhere else – and by a significant margin. Cases in Vermont were almost double those recorded in the other 50 states.

Why Vermont and Missouri?

And in the London financial sector the huge stresses and emotions with winning or losing major contracts, deals and large sums of money during trading may have a similar effect for the executives, bankers and lawyers involved.”

What is broken heart syndrome?

Extreme stress and trauma, such as that which follows the loss of a life-long partner or the loss of your home and multiple family members in a natural disaster, causes physical damage to the heart tissue. This induces symptoms that are similar to those of a heart attack. “Adrenaline can trigger a number of symptoms from the heart, including chest pain, breathlessness and a thumping or fast heart beat (palpitations),” explains Dr Lyon. When people are examined, however, the tests for blocked coronary arteries come back negative or inconclusive.

With supportive care, people can recover over the following few months but around 25% experience arrhythmias, episodes of erratic heartbeats, which can be highly dangerous during the acute ‘storm’. Up to 7% of people with Takotsubo cardiomyopathy suffer a cardiac arrest and some die of their condition. Fortunately though, most people with Takotsubo syndrome make a good recovery.

What new research is telling us

The research by Dr Lyon and his team at Imperial College suggest the temporary paralysis of the heart that occurs in the first stages of Takotsubo myopathy is paradoxically protective.

However, in his experience there are a number of individuals who have ongoing problems after the stressful event, including chest pains, palpitations and/or breathlessness for many months after the acute episode.

He has a number of strategies to help support and identify the nature of these symptoms, applying treatment where appropriate to help people get past this frightening post-traumatic illness.

Diagnosing broken heart syndrome accurately

“We now have expertise to clarify whether the symptoms experienced are from such adrenaline rushes and Takotsubo-like phenomena versus underlying coronary or other heart diseases.

It’s important that we raise awareness of the risk of the condition after major traumatic events so that people are not misdiagnosed. With an accurate and prompt diagnosis followed by good supportive treatment, a higher overall recovery rate could be achievable.”  

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