Doctors looking for 'broken heart' syndrome
Extreme stress can trigger what seems to be a heart attack, but is really something known as broken heart syndrome.
Extreme stress can trigger what seems to be a heart attack, but is really something known as broken heart syndrome.
Unlike conventional heart attacks stemming from blocked arteries, broken heart syndrome, or stress cardiomyopathy, is caused by an extended surge in adrenaline, such as after a car crash or even learning of the death of a loved one. It may only require short-term treatment because the heart usually recovers by itself.
Researchers from the Johns Hopkins University School of Medicine, USA, found some people may respond to sudden, verwhelming emotional stress by releasing large amounts of adrenaline and other chemicals into the blood stream. These chemicals can be temporarily toxic to the heart, effectively stunning the muscle and producing symptoms similar to those of a typical heart attack: chest pain, fluid in the lungs, shortness of breath and heart failure. But the similarities end there. Closer inspection using blood tests and magnetic resonance imaging scans failed to show the typical heart attack signs, such as irreversible muscle damage and elevated levels of certain enzymes.
Ability to recognise broken heart syndrome in patients helps avoid incredibly invasive procedures.
The researchers cited the case of a 27-year-old who developed severe shock with very low blood pressure after hearing tragic news. She appeared near death and surgeons were prepared to implant a mechanical pump in her chest. But the operation was delayed when doctors recognised the signs of broken heart syndrome. Not only did she not require an open-heart surgery, she was discharged from the hospital three days later and has regained completely normal heart muscle function.
The researchers cautioned that even a stress-induced heart attack can't go untreated. There may be underlying heart disease that must be addressed, and the symptoms of broken heart syndrome, if severe enough, must be dealt with quickly.
Further research is needed to study whether certain patients have a genetic vulnerability for the condition, and why it predominantly strikes older women.
The New England Journal of Medicine,
February 2005
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