Much research has surrounded stress cardiomyopathy, or Broken Heart Syndrome. When couples who have lived together for years, loses his/her partner, we often hear of their death within months, if not weeks later. The official name of Broken Heart Syndrome (BHS) is Takotsubo cardiomyopathy, where cases have been seen in Japan, the US and many other countries. The stress of a loved one puts such strain on their heart that they are too vulnerable to withstand the injury. The heart tries to compensate by enlarging and we see a bulging apex of the heart in these patients.
Actress Debbie Reynold’s lost her daughter Carrie Fisher one day prior and then herself became ill with possible “stroke”. She passed later that day, with one report citing her last words were “I want to be with Carrie”.
What makes Broken Heart Syndrome so unique is its a rare and possibly fatal disease initially induced by stress. Mind over matter plays a key part here.
What occurs in Broken Heart Syndrome?
Unlike heart attacks which are usually caused by clogged arteries, BHS appears to be induced by a rush of stress hormones. These include cortisol and adrenaline. Paramount stressors such as losing a child or spouse would be enough to start the cascade. Then come chest pain, shortness of breath, blood pressure changes, the heart enlarges to compensate for low output, arrhythmia can occur and this list goes on. Heart failure or cardiogenic shock can occur when the heart cannot pump enough blood to the body.
How does Broken Heart Syndrome differ from a heart attack?
BHS if identified early can be treated promptly. If arteriosclerosis is absent, then surgery wouldn’t be needed to bypass the blood vessels or clear out the arteries. Treatment of BHS would include medications most typically used in heart failure patients (diuretics, ACE inhibitors, betablockers) to reduce the work load on the heart. If a heart attack did occur during the BHS period, or inducing BHS, protocols for heart attack treatment would executed immediately. BHS patients without coronary artery disease) are more likely to recover quicker than heart attack victims.
How do we prevent Broken Heart Syndrome?
When living in stressful times, its imperative to be around friends and families, support groups, etc. The stress is the inducing component and although it will not be eliminated entirely, could be managed constructively. Avoiding alcohol and tobacco and poor diet habits are also key. Asking for help is life saving, and those who see a loved one suffering offer your support immediately.
In addition, make sure you are taking care of yourself. A medically unstable family member may not be strong enough to go on after losing their closest loved one. The grieving process is a healthy process however, and should not be avoided. Distraction may help, focusing the love for the lost family member into a cause/scholarship/foundation can also be helpful in the grieving process.
The last thing we haven’t discussed is guilt. When a loved one dies, we feel guilty over how we treated, spoke to, and spent time with them. This guilt will consume you. While you have your loved ones with you, remember that any day could be their last and let them know you love them.
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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician