What happens in broken heart syndrome, exactly?

What is it?

Broken heart syndrome, also known as Takatsubo cardiomyopathy or stress cardiomyopathy, is a condition in which the muscular part of the heart is suddenly and temporarily weakened. The condition gets its name from the fact that this weakening can be triggered by emotional stress.Broken heart syndrome can lead to serious complications like heart failure. Its main symptom is a suddenly beginning chest pain, and if an EKG is taken, it mimics a heart attack. Broken heart syndrome affects about 2-3% of people who suffer an myocardial infaction in  western countries, and it is most common in older people.

What causes it?

Over 85% of cases are caused by psychological or physical stress. Examples of possible situations include the death of a loved one, a break-up, being forced to speak in public, and having an argument with someone.

What happens during it?

The exact mechanism of broken heart syndrome is unknown, but there are several propositions.

Molecules like adrenaline are released to our blood when we face stress. Their purpose is to prepare us for whatever future challenge our body thinks we’re facing. We have evolved to get stressed when we, say, encounter an aggressive bear, and molecules like adrenaline prepare us to fight or flight by for example increasing blood flow so that our muscles are sure to get enough oxygen. It is thought that an excessive concentration of these molecules could be toxic to the heart, although the mechanism of this is not fully understood. Too much of these molecules are thought to make the heart muscle cells kill themselves, and as they start operating a bit differently to protect themselves from this fate, it is thought that they at the same time lose some of their function.

How can it be treated?

The treatment of broken heart syndrome mainly aims to support the body’s own recovery. A number of different medications can be helpful in this. Most patient’s hearts have returned to normal function in two months, and very few end up actually dying because of the condition. After the acute phase of broken heart syndrome is over, it is important to talk the patient through what changes to their lifestyle they would have to make in order to stay healthy in the future. These changes include getting out of stressful situations and learning how to cope with stress when it’s unavoidable.




Sources: https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110608/, https://www.ncbi.nlm.nih.gov/pubmed/24398587


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