Death by Broken Heart Syndrome

brokenheartThere’s a 30-year old woman, Erica. Erica is a NYC stockbroker with a caring fiancé and everything a woman could dream of. She exercises at least five times a week and has a mostly healthy diet. However, she is always anxious about her work and has recently been very agitated about her upcoming wedding because she wants it to be perfect. Erica also has an irregular sleep schedule. She has been told by many people that she has a short temper. Two weeks before the wedding, Erica is told that she might lose her job because of a failed project that cost her company a lot of money. And the next week she finds out that her fiancé has been cheating on her with his ex-girlfriend. The wedding is called off, and Erica is now at a city hospital being treated for heart failure.

Let’s rewind. A 30-year old woman who exercises regularly and eats healthy suffered from a heart attack, although one wouldn’t call it a “heart attack” so much as simply immediate heart failure. Erica’s condition represents a case of takotsubo (stress) cardiomyopathy, or, as many know it, Broken Heart Syndrome. You might be wondering if this is even a real condition. I mean come on, can you really die of a broken heart? Well in some rare cases, yes. Broken Heart Syndrome occurs when the heart muscles weaken from an influx of emitted stress hormones, usually triggered by a traumatic and emotional event. Overwhelming emotional stress may cause some people to release a large amount of catecholamines (stress hormones) into the blood [1]. These stress chemicals can be detrimental to the heart, harming the muscle and generating symptoms very similar to those of a typical heart attack, such as pain, discomfort, shortness of breath, and, in some cases, heart failure.

The strange thing is that Broken Heart Syndrome is often misdiagnosed for a heart attack even though the two are completely different as far as their effects on the heart and the main cardiac arteries. First, one can encounter Broken Heart Syndrome without having pre-existing risk factors, whereas this is not the case for a normal heart attack. Second, the damage caused by BHS is far less severe and is reversible compared to the sometimes permanent damage from a heart attack. A heart attack can result in permanent damage to the heart due to cardiomyopathy. In the case of takotsubo cardiomyopathy, the muscles of the heart dilate, keeping the inside of the heart intact while the outside swells [2].

A third difference between BHS and a typical heart attack is the recovery period and mortality rate. One of the most notable characteristics of stress cardiomyopathy is the very short recovery period and low mortality rate. With BHS, the recovery time can fall between a few days to a couple weeks, due to the minimal severity of the condition to the heart muscles. However, during a typical heart attack, the patient would be in a hospital bed for weeks possibly even months depending on the severity. Nevertheless, stress cardiomyopathy can still be potentially fatal because it can still cause heart failure and in untreated cases lead to death.

Broken Heart Syndrome effectively proves how important emotional health can be to physical well being. The very chemicals that are meant to save us from danger cause this ailment. According to cardiologist, Dr. Tracy Stevens, the body cannot tell the difference between danger and stress, so, in times of high stress, the chemicals cortisol and adrenaline are released. The two chemicals are integral to the human fight-or-flight response [3]. Adrenaline makes the heart pump faster, which in some cases can cause the arteries to rupture. This can lead to a heart attack and general weakening in the cardiac muscles. On the other hand, adrenaline aids our bodies in achieving things we couldn’t possibly think of, such as lifting heavy objects or running long distances while maintaining stamina. However in the case of stress cardiomyopathy, adrenaline can become our heart’s greatest adversary.

Cortisol, the ultimate stress hormone, is often overlooked when it comes to its effects on the body. However it plays a crucial role as a potential antagonist to our general health. Conversely, it is also responsible for maintaining normal blood pressure and blood sugar levels. However, in excess, it can lead to serious complications. Two of the main harms that cortisol can cause the human body are cardiovascular disease due to hypertension and long-term debilitation of the immune system [3]. Studies have shown that excess cortisol levels in the body are harmful and affect almost all of the body’s processes. Health risks include cardiovascular disease, digestive disorders, depression, memory impairments, and sometimes even cancer. Too much cortisol can be lethal [4]. Excess cortisol produced from stress makes the body weaker and more prone to other ailments.

Through science, we’ve seen how stress can make our bodies (especially our hearts) weaker, and how people, like Erica, can become affected by BHS. Women are 55 percent more likely to suffer from Broken Heart Syndrome than men [2]. The reason is still unknown, as are many other lingering questions about this disease. Needless to say, it is clear that extreme emotional stress takes a negative toll on our bodies because of the influx of potentially harmful chemicals and hormones into our bloodstream. The one hope for Broken Heart Syndrome and stress-related ailments is that they are highly reversible and sometimes even preventable. Activities such as meditation, yoga, and physical exercise, can usually aid in mental and emotional health and allow for healthier bodily functioning. Thus, it is always important to be able to manage stress and deal with it strategically to avoid overwhelming emotions. One can actually have a “broken heart,” and it can cause serious problems. So the next time someone tells you “you’ll break my heart,” you’ll want to take it a bit more seriously.

References

[1] Wittstein, Ilan. ““BROKEN HEART” SYNDROME: REAL, POTENTIALLY DEADLY BUT RECOVERY QUICK.” Johns Hopkins Medicine. February 9, 2005.

[2] Sharkey, Scott, John Lesser, and Barry Maron. “Takotsubo (Stress) Cardiomyopathy.” American Heart Association: Circulation. January 1, 2011.

[3] Pham, Jennifer, Steven Bruhl, and Mujeeb Sheikh. “COPD Exacerbation with Concurrent Stress Cardiomyopathy: A Case of Double Dyspnoea.” British Journal of Medical Practitioners. January 1, 2011.

[4] Whitworth, Judith, Paula Williamson, George Mangos, and John Kelly. “Cardiovascular Consequences of Cortisol Excess.” US National Library of Medicine. December 1, 2005.

Image References

[1] “Heart, Broken, Patched, Patch – Free Image on Pixabay.” Free Vector Graphic:. Accessed March 19, 2015. http://pixabay.com/en/heart-broken-patched-patch-symbol-48522/.

 

Alireza Esfandiari is a pre-med student at the George Washington University, specifically interested in cardiology. Follow The Triple Helix Online on Twitter and join us on Facebook.

You May Also Like