written by Jillian Pinks, VirtuALZ RN
February is American Heart Month and is an ideal time to focus on heart health awareness. Heart disease, in general, is a common topic of conversation. But a lesser-known condition, first described in 1990 in Japan, primarily affects women. This condition is called Broken Heart Syndrome.
In Broken Heart Syndrome, the heart's main pumping chamber is affected, and the left ventricle is often weakened. Broken Heart Syndrome is so named because it is usually the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, a serious accident, surgery, a natural disaster, or other emergencies.
This condition briefly interrupts the way the heart pumps blood by squeezing the large or small arteries of the heart, which also changes the heart's structure. The rest of the heart continues to work as usual. It is important to note that this syndrome is temporary, and the heart can recover with appropriate treatment and care.
Broken Heart Syndrome has many names.
Some of these include:
Stress cardiomyopathy
Takotsubo (named after an octopus trap) cardiomyopathy
Recurrent Takotsubo Cardiomyopathy
Apical ballooning syndrome
Symptoms of Broken Heart Syndrome
Broken Heart Syndrome symptoms can mimic a heart attack. Symptoms may present within one minute to an hour after an emotionally or physically stressful event. It is important to be familiar with the symptoms. They may include:
Chest pain
Shortness of breath
Diaphoresis (sweating)
Dizziness
If you begin experiencing shortness of breath, call 911 immediately. If you have new or unexplained chest pain or if your heart is beating rapidly or irregularly, call 911.
What Causes Broken Heart Syndrome?
The exact cause of Broken Heart Syndrome is unknown. But there is some consensus that it can be brought on by experiencing a stressful event. During stress, the body will produce hormones and proteins to help cope. These hormones, including increased adrenaline levels, can cause the heart muscle to become overwhelmed.
As a result, the small arteries that provide the heart with blood can narrow, causing a temporary decrease in blood flow.
This sudden increase in adrenaline binds to the heart cells, which causes a large amount of calcium to enter the heart cells, preventing the heart from beating properly. Fortunately, this is a temporary and reversible condition within a few days or weeks with proper medical care. Extreme emotional or physical stress is often considered a cause of Broken Heart Syndrome.
Those stress events may include:
Sudden illness such as an asthma attack
Major surgery
Sudden broken bone
Death of a loved one or other significant loss or grief
Strong argument (anger)
Fear
Sudden surprise
High fever
Stroke
Seizure
Significant bleeding
Low blood sugar
A sudden drop in blood pressure
While rare, using certain drugs may lead to Broken Heart Syndrome. Some examples include:
Emergency medicines to treat severe allergic reactions or severe asthma attacks
Some medications to treat anxiety
Nasal decongestants
Illegal stimulant drugs, such as methamphetamine and cocaine
Informing your healthcare provider about the medications you take, including those which do not require a prescription, is important in any situation, especially this one.
While Broken Heart Syndrome may present like a heart attack, it is, in fact, quite different. A blockage of the heart artery causes heart attacks. In Broken Heart Syndrome, the heart's blood flow is reduced but not blocked.
A history of depression or anxiety increases the risk of experiencing Broken Heart Syndrome. Let your healthcare provider know if you have experienced either of these at any time. It is also important to note that Broken Heart Syndrome affects more women over 55 than any other demographic.
Most people with Broken Heart Syndrome recover quickly and don't have long-lasting effects if monitored by a healthcare professional familiar with this affliction. Though rare, this condition can occur again and is referred to as Takotsubo Cardiomyopathy. It is very rare for Broken Heart Syndrome to result in death.
While the recovery can be quick, there can be complications. These complications can include the following:
The backup of fluid into the lungs is called pulmonary edema
Low blood pressure
Irregular heartbeats, also known as arrhythmias
Congestive Heart failure
Blood clots in the heart
Shock
How is Broken Heart Syndrome Diagnosed?
Because the symptoms of Broken Heart Syndrome can mimic a heart attack, many patients are often diagnosed during an emergency. Your doctor will examine you and ask about your symptoms and medical history. Sharing as much detail as possible will give your doctor a fuller picture of your health.
You should also include information about stress, anxiety, and emotionally and physically challenging situations you have recently experienced. Listed below are some suggested topics to share with your medical professional. If possible, try to have a friend or family member with you for help and support as you navigate the process.
Important Information to Share with your Healthcare Provider:
The symptoms you are experiencing and how long you've had them
Life changes and personal information, such as significant stress, the death of a loved one, the loss of a job, a new stressful job, relocation, etc.
Personal and family medical history, including health conditions such as diabetes, high cholesterol, heart disease, or mental and emotional health conditions
A list of the medications you take, including those not requiring a prescription
Any recent injury to your chest that may have caused internal damage, such as a broken rib, pinched nerve, car accident, or sports injury
Questions to Expect from your doctor:
When did the symptoms begin?
Does your pain spread to any other parts of your body?
Does your pain briefly get worse with each heartbeat?
Can you describe your pain in your own words?
Does exercise or physical activity make your symptoms worse?
Is there a family history of heart problems?
Are you being treated, or have you recently been treated for any other health conditions?
Why do you think you have these symptoms?
Your doctor may do a series of tests based on your provided information. Five different diagnostic tests can help identify Broken Heart Syndrome. These tests are:
Blood tests. Your Cardiac Enzymes will be tested. High levels may indicate Broken Heart Syndrome.
Electrocardiogram (ECG or EKG). Your doctor can determine the heart's rhythm by measuring the heart's electrical activity. This painless test is performed by placing electrodes on your chest, arms, and legs. These electrodes connect to a computer that issues immediate, real-time results.
Coronary angiogram. This test will look for blockages in the arteries. A heart attack may be ruled out if there are no blockages.
Echocardiogram. This test uses sound waves to create pictures of the heart in motion. It reveals how blood flows through the heart and valves, showing if the heart is enlarged or has an unusual shape.
Cardiac MRI. This test uses magnetic fields and radio waves to create detailed heart images.
Feeling concerned and possibly overwhelmed regarding your heart health and condition is natural and normal. Gaining a greater understanding and knowledge of your heart health may bring you much-desired peace of mind and confidence.
Questions you might consider asking your healthcare professional:
What do you think might be causing my symptoms?
I recently experienced a very stressful time; could my symptoms be due to this event?
What kinds of tests do I need?
Do I need to stay in the hospital?
What treatments do I need right now?
What are the risks associated with these treatments?
Could this happen again?
Do I have any diet or activity restrictions?
Treatment and Medications
Once it is determined you have Broken Heart Syndrome, a treatment plan will be developed by your doctor. Although there is no standard treatment for Broken Heart Syndrome, there are methods and practices your doctor might recommend or prescribe. Until a precise diagnosis has been determined, the symptoms might be treated as though a heart attack has occurred.
While most patients will recover within a month or so, they should remain under their doctor's care. Your doctor may recommend additional tests toward the end of the treatment plan to confirm that your heart has recovered. Some patients may qualify for cardiac rehabilitation or physical therapy based on the doctor's recommendation.
Once the diagnosis of Broken Heart Syndrome has been determined, medicines may be prescribed to reduce the strain on the heart and help prevent further episodes. These medications may include:
Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin II receptor blockers (ARBs)
Beta-blockers
Diuretics
Blood thinners, if there is a blood clot
Your doctor will determine the best medication for your diagnosis. It is crucial that your current list of medications is up to date and includes any medicines that do not require a prescription.
Ways to Prevent Another Broken Heart Syndrome Episode
Chronic stress may increase the risk of Broken Heart Syndrome. Taking steps to manage emotional stress can improve heart health and may help prevent a reoccurrence.
Some ways to reduce and manage stress include:
Exercise or movement of the body
Practice mindfulness
Biofeedback, meditation
Yoga
Connect with others in support groups
Eating a Mediterranean Diet
Recovery from Broken Heart Syndrome
Recovery from any heart condition is optimized when you have emotional support. Many communities offer support groups specifically for Broken Heart Syndrome, consisting of patients, survivors, and caregivers. Asking your doctor about resources is one option. Following doctor's orders and having access to support is essential to recovery. Members of VirtuALZ can contact their Care Navigation Team to learn more about support groups and resources in their area.
Sources:
Takotsubo cardiomyopathy (broken-heart syndrome) https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome
Wittstein MD, Ilan Shor. Broken Heart Syndrome. https://www.hopkinsmedicine.org/health/conditions-and-diseases/broken-heart-syndrome
Broken Heart Syndrome https://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/symptoms-causes/syc-20354617#:~:text=Broken%20heart%20syndrome%20is%20a,after%20the%20heart%20is%20healed.
Note: The VirtuALZ blog (FYI) is strictly a news and information website about Alzheimer’s Disease and Related Dementias and life over 60. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. The VirtuALZ Blog (FYI) is intended to spark discussion about issues pertaining to Alzheimer’s disease.