What is Broken Heart Syndrome
Broken heart syndrome is a temporary heart condition that’s often brought on by stressful situations, such as the death of a loved one. People with broken heart syndrome may have sudden chest pain or think they’re having a heart attack. In broken heart syndrome, there’s a temporary disruption of your heart’s normal pumping function, while the remainder of the heart functions normally or with even more forceful contractions.
Broken heart syndrome may be caused by the heart’s reaction to a surge of stress hormones. The condition may also be called takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy by doctors.
The symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in about a week.
Causes of Broken Heart Syndrome
There are various theories as to what causes the condition. About three quarters of those diagnosed with Takotsubo cardiomyopathy have experienced severe emotional or physical stress prior to becoming unwell, such as bereavement.
British Heart Foundation (BHF) says evidence suggests the sudden, excessive release of hormones usually adrenaline – during these stressful periods causes the ‘stunning’ of part of the heart muscle.
Interestingly, research conducted by Imperial College London in 2012 found the condition may actually protect the heart from very high levels of adrenaline.
Professor Sian Harding, from the National Heart and Lung Institute (NHLI) at Imperial College London, who led the study, explained: “In patients with Takotsubo cardiomyopathy, adrenaline works in a different way and shuts down the heart instead. This seems to protect the heart from being overstimulated.”
Heart attack and Broken Heart Syndrome: What’s the difference?
Some signs and symptoms of broken heart syndrome differ from those of heart attack. In broken heart syndrome, symptoms occur suddenly after extreme emotional or physical stress. Here are some other differences:
- EKG (a test that records the heart’s electric activity) results don’t look the same as the EKG results for a person having a heart attack.
- Blood tests show no signs of heart damage.
- Tests show no signs of blockages in the coronary arteries.
- Tests show ballooning and unusual movement of the lower left heart chamber (left ventricle).
- Recovery time is quick, usually within days or weeks (compared with the recovery time of a month or more for a heart attack).
Broken Heart Syndrome Symptoms
Broken heart syndrome symptoms can mimic a heart attack. Common symptoms include:
- Chest pain
- Shortness of breath
Any long-lasting or persistent chest pain could be a sign of a heart attack, so it’s important to take it seriously and call 911 if you experience chest pain.
How common is Broken Heart Syndrome?
The BHF estimates that takotsubo cardiomyopathy affects 2,500 people in the UK each year. Between one and two per cent of people who are initially believed to have had a heart attack are found to have experienced the syndrome at a later date, according to Imperial College.
Dr Alexander Lyon, a consultant cardiologist at the Royal Brompton, told The Guardian that more people may be dying suddenly of the condition before reaching hospital without it being accurately diagnosed before or after their death.
He said this can be particularly difficult with men who may have died from the syndrome.
“The pathologist opens the heart, sees some signs of coronary artery disease, because in western society pretty well all adult men will have evidence of it, and so records coronary heart disease as the cause of death,” he explained.
“And with deaths in custody, we know that hearts are very often normal when examined, so this syndrome becomes relevant. It may be happening far more often than is reported.”
Diagnosing a Broken Heart
Clues that may help lead your doctor to the right diagnosis are your age and gender. More than 90% of cases reported thus far have been in women.
It’s especially common after menopause. Lisa Wysocky was 52 when she had her encounter with broken heart syndrome.
Some research suggests that about 2% of people who seem to be having a heart attack actually have broken heart syndrome. Among women, the number may be higher than 5%.
If you’ve just gone through grief, stress, or emotional trauma, mention it to your doctor, Wittstein says. Also bring up recent physical stress such as an asthma flare-up or low blood sugar, he says. These can also trigger the problem.
To diagnose broken heart syndrome, doctors usually perform an angiogram. This provides images of the major blood vessels that supply your heart. During a heart attack, one or more arteries are often blocked. But during broken heart syndrome, these blood vessels look OK.
Your doctor is likely going to want to also perform an echocardiogram. This takes pictures of your heart, which may reveal the tell-tale fishing pot shape.
Risk factors of Broken Heart Syndrome
Broken heart syndrome affects women far more often than men. It appears that most people who have broken heart syndrome are women 50 or older.