 Broken heart syndrome may often be confused with symptoms of a heart attack. Virtually every day throughout America men and women are being treated for are being treated for chest pain and other symptoms associated with having a heart attack, but many of these people symptoms are not caused by heart disease, but rather by a broken heart.
A number of moths ago, a patient of mine was seen at a local ER for severe left chest pain. Upon arrival by ambulance the doctors hooked her up as usual to an, IV and a series of very sophisticated monitors. For several hours they poured over her and responded to her symptoms but at first they were confused as her electrocardiograms were normal. Finally, they told her that they did not believe that she had experienced a heart attack, rather they told her that they believe that she was experiencing an attack of angina. It wasn’t until her own cardiologist finally arrived that they finally obtained a most important and crucial piece of information, her and 55 year old son, had died earlier that afternoon of an overdose of cocain. She then spent the afternoon on her bathroom floor after experiencing chest pain until her husband finally found her and called the ambulance. She later told her doctor, that she had been too upset with grief and pain (chest pain) to seek help for her self.
After running thousands of dollars in tests, her cardiologist finally told her that she had not had a heart attack, rather she had an entirely different type of heart problem called stress cardiomyopathy. He told her that it was not caused by hardening of her arteries but rather by her broken heart, he called it "broken heart syndrome." While the symptoms are real issue, and initially appear to be caused by a heart attack, the pathology is different.
Understanding broken heart syndrome requires that you understanding how the body can and does react to stress. It also requires that you understand that this syndrome can be a lethal as a real heart attack and every years hundreds, maybe even thousands of people suffer broken heart syndrome and as of now, an unknown portion of them actually die from it.
Stress Can Lead to a Broken Heart
The term "broken heart syndrome" came about after researchers noticed that many people with the condition were grieving, mourning or where experiencing stress of significant degree. While some of these individuals had recently experienced the death of a loved one, a spouse, a parent or a child, others occurred in the midst of a divorce, after losing a job or associated with sever financial problems. Still others may have just gone through a trauma such as a car accident or a mugging. One woman landed in the intensive care unit on her 60th birthday after being startled by well-wishers shouting "Surprise!"
Any event associated with a real or even imagined fear or threat of injury or loss can trigger the sympathetic nervous system, to activate an individuals "fight or flight" mechanism and thereby trigger a reaction from the heart do to increased blood pressure, shunting of blood from the gastrointestinal system to the muscles and either to or away from the heart as the body is shocked and readies itself for fight or flight.
During the activation of the stress mechanism the body releases a flood of chemicals, including adrenaline which can stun your heart muscle, leaving it unable to pump properly. When this happens
the heart muscles can be profoundly affected so that they can not pump blood out out of the heart to the rest of the body. As a result heart failure may develop. Under these circumstances while the body is preparing to fight or flight failure of the heart to work correctly can end up becoming a life-threatening problem. People can actually die when this happens. You have heard of people dying from shock this is exactly what is happening here.
Initially the symptoms can be so similar to those of a traditional heart attack that person experiencing them, their family, friends, the paramedic, and even many ER doctors may reasonably believe that the individual is having a heart attack. In other words, they may not know the difference between what is happening and the possibility of a blocked artery causing a heart attack.
The symptoms of broken heart syndrome are:
- Chest pain
- Shortness of breath
- Arm pain
- Sweating
Because traditional heart attacks can also be triggered by stress, no one should take any chances. The problem should be treated as if they were having an actual heart attack.
If you find your self experience stress and suddenly start having chest pain, you shouldn't question whether this could be stress cardiomyopathy occurring just because you're going through a stressful period or whether you are having an actual heart attack. Call 911 or get to the closest hospital and let the doctors sort out what is actually happening.
Diagnosing a Broken Heart
There are a number of valuable clues that might help your doctor to make the right diagnosis. They include both your age and gender. Also if you are going through some significant stressful experience make sure your doctor knows about this. Generally, more then 90% of people experiencing broken heart syndrome are women, most are over 50 years of age and most are post menopausal women. This does not mean that it cannot happen to men or younger women so once again, get help first and sort out the details later.
To date the best suggestion is that somewhere around 2% of people who seem to be having a heart attack are actually have broken heart syndrome. Among women, the number may be bit higher than 5%.
Stress and What to Do About It?
If you experiencing mourning, grief, stress or any other significant emotional trauma get help. Indications suggest hat if you can treat the symptoms of stress early they are less likely to lead to broken heart syndrome. Also if you experience any recent physical stress such as a flare-up of asthma, low blood sugar, severe intestinal problems, or pain. These can also trigger an episodeof broken heart syndrome.
In order to diagnose broken heart syndrome most doctors will probably want to perform an angiogram. This test can provide information regarding 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 will look entirely normal. Since this test is not without lifethreatening danger on it own we strongly suggest you consider some preventive treatments before you are having any chest pain or problems. This can mean controlling cholesterol, evaluating your risk for heart attack and in our office chelation therapy to undo any existing coronary artery disease.
We would also order an echocardiogram to evaluate the shape of your heart, to look for any indication of enlarged heart that might be consistent with early heart failure. This procedure has no risk to your heart or well being associated with it so it is safe to do early before you are experiencing any problems to protect you from heart failure.
Broken Heart Syndrome Is Not A Death Sentence
One of the most remarkable aspect of broken heart syndrome is that an individual experiencing broken heart syndrome can be critically ill on a Monday and being discharged to go home on Thursday. Since there is no permanent damage to the heart or its muscles, recovery is generally fairly rapid. Obviously, this is not the case after someone has a major heart attack.
The main post event treatment is a prescription for either ACE inhibitors or for a beta blocker. Even this is only for a limited time, until the stress is resolved and the individual is back to normal.
As to the patient described above after she was discharged from the hospital with a prescription for an ACE inhibitor. I saw her two days later and referred her for grief counseling. She has done very well. She is still mourning but she has had no further heart problems, and was also started on a low dose anti-anxiety drug to help her in the immediate after math and we expect that she should be off of this medication in the next four to six months. She is grateful that her doctors were able to diagnose her condition as a short-term problem and she is optimistic that she will regain her balance in the near future.
For more information about Stressand Stress-Related Disorders, click here.
For more information about Heart Attack, click here.
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