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How to treat broken heart syndrome?

by Dr Prem Community Writer
broken heart syndrome

The term broken heart is often used as a metaphor to describe a severe emotional and mental stress resulting from a serious loss. But it can be a clinical condition that may even lead to death. A seemingly healthy person suddenly collapsing to death on receiving the news of a severe loss or an unexpected gain can be due to broken heart syndrome.

Normally, it would be viewed as a cardiac arrest caused by some undiagnosed arterial blockages. In reality, it may be the emotional stress causing this attack. Then how to treat broken heart syndrome? Is an early diagnosis possible?

In the US and UK, the month of February is observed as the Heart Month to focus public consciousness on heart related clinical issues. This includes a rather peculiar heart condition arising from mental anguish.

Emergence of the ailment- Takotsubo Cardiomyopathy:

Takotsubo-CardiomyopathyImage Source : img.medscapestatic.com

Takotsubo Cardiomyopathy, which is more popularly called the broken heart syndrome, was first registered as a medical case in Japan. It was back in 1990. The shape of the heart of affected patients resembled a fish called Octopi caught by a traditional Japanese fishing pot. The term is coined from the name of this pot.

Signals of this syndrome are similar to a heart attack. Acute chest pain and shortness of breath is present in broken heart syndrome as well. However, blockage of arteries, which is the underlying cause of heart attack, is absent in this case. How to treat broken heart syndrome is still undergoing research work.

Medications and other treatment options exist, providing relief to the patient in a week. However, much of medical science is yet to divulge more information on broken heart syndrome.

Typical features of Broken Heart Syndrome:

Difficulty in breathingIn broken heart syndrome, the capability of the heart to contract and relax falls drastically. Here comes its similarity with myocardial infarction commonly known as heart attack. Typical signs will be:

  • Acute pain in the chest.
  • Difficulty in breathing.
  • Breaking out in profuse sweating.
  • Nausea and a strong urge for retching.
  • Weakness and exhaustion.
  • Erratic heartbeat.
  • Heart failure resulting from an excess of fluid in heart and pulmonary edema.
  • Irregular readings in electrocardiogram similar to that of heart attack symptoms.
  • Absence of blockage in coronary arteries.
  • Anomaly in the left ventricular movement.
  • Left ventricle swells up, enlarging in size.

Biological reasons behind broken heart syndrome, still an obscure domain:

Biological reasons behind broken heart syndromeTo treat broken heart syndrome, the insight into its source from a scientific angle is imperative. According to the Associate Medical Director of Aberdeen University, Professor Metin Avkiran, broken heart syndrome is still an enigma that is to be explored.

However, it is a medical breakthrough that there is a close relationship between Takotsubo Cardiomyopathy and inflammation inside heart. Causes for inflammation are yet to be investigated to prescribe proper medication and other treatment options.

In a medical investigation conducted by New York University School of Medicine’s cardiovascular center, startling findings came to light. Women with broken heart syndrome had irregularities in their parasympathetic nervous system. This system regulates involuntary functions of the body when they are at rest, like while sleeping.

Having a concrete clue to the causes would not only help treat broken heart syndrome. It will also facilitate follow up care, observed Doctor Dana Dawson, lead Researcher and Chairman of Aberdeen University’s cardiovascular medicine department.

Misnomer in the term broken heart syndrome and emotional stress:

Loss of employmentSeveral case studies show stress doesn’t always come from mental grief. Most of the cases of broken heart syndrome brought under clinical probe did not arise from emotional agony. So rather than calling it a broken heart syndrome having its roots in melancholy, the proper term would have been stress induced cardiomyopathy. Emotional stress doesn’t follow from just a relationship break up. Probable causes of Takotsubo Cardiomyopathy are:

  • Relationship break ups.
  • Serious financial issues.
  • Loss of employment.
  • Extreme anxiety at specific moments like while delivering a speech in public.
  • Asthma assault.
  • Trauma of hearing bad news.
  • Violent quarrel.
  • Intense panic.
  • Severe pain.
  • Domestic abuse.

Everyone is susceptible to broken heart syndrome, but in most of the cases it strikes women around 50 years and above. Death of a near and dear one could ruin your mental and physical health. You take the shock directly to your heart.

A chemical overflow comes into play that is very damaging for your heart health. It could be over secretion of the stress hormone adrenaline too stressful for your heart to bear and hence its collapse becomes inevitable.

Takotsubo Cardiomyopathy and cancer:

CancerTo treat broken heart syndrome well, your investigation and diagnosis should be accurate for fruitful results. While exploring the causes, several facts come up. One such equation is relationship of broken heart syndrome with cancer.

When data from 1600 patients collected by International Takotsubo Registry were studied, it revealed interesting findings. Out of 6 patients, 1 had cancer and 90 % were females. Cancers ranged in types – the most common being breast cancer followed by cancer of gastrointestinal system, respiratory tract, internal sex organs, skin and other areas of body.

Compared to non cancer affected patients with broken heart syndrome, the emotional and physical impulse received by cancer patients with broken heart syndrome was almost double. They have higher chances of death within 5 years from the time the syndrome set in.

Cancer patients having broken heart syndrome would require intensive heart and respiratory support while struggling for survival. But these patients are likely to survive a month since the syndrome had started. How cancer and broken heart syndrome is linked in is under study.

Remedial procedure for broken heart syndrome – diagnosis and treatment:

ElectrocardiogramTo treat broken heart syndrome properly correct diagnosis is a pre- requisite. Diagnosis will be along following lines:

  • The treating physician would require family history of the patient together with prescribed physical tests. Generally, it has been observed people with Takotsubo Cardiomyopathy do not have a history of heart ailments.
  • An Electrocardiogram (ECG) test is conducted, which is non invasive. Technicians put wire across chest to record electrical impulses making your heart beat. Report will locate anomalies in the structure of heart and in its beating rhythm.
  • A blood test is conducted to check if there is an excess of enzymes present in blood which is a reason for people having broken heart syndrome.
  • A chest X- Ray is done to evaluate shape of the heart. If the heart is shaped like the Japanese fishing pot, possibility of broken heart syndrome can’t be ruled out.
  • Cardiac magnetic resonance imaging: The patient is put in a magnetic field generated by a tube like machine. A picture of your heart is created by the field for further appraisal to treat broken heart syndrome if you are diagnosed with one.
  • Coronary Angiogram: An X-Ray visible dye is introduced to the patient’s blood vessels of the heart. A series of images of blood vessels is shot by x ray machine. If the image shows no blockage, the presence of Angina leading to heart attack is ruled out.

Treatment:

MedicationsThe most feasible way to treat broken heart syndrome would mean reinforcing impaired heart muscles so that they get back strength and patient recovers fast. Though there isn’t any standard treatment procedure as yet and much of it is still in research stage.

Medications are usually Beta- blockers and angiostensins that convert enzyme inhibitors and diuretics. These help reduce stress on heart. Another effective mode to treat broken heart syndrome is to take complete rest in hospital while recovery is in progress.