Broken Heart Syndrome
Broken heart syndrome is a temporary heart condition that’s often brought on by stressful situations, such as the death of a loved one. The condition can also be triggered by a serious physical illness or surgery. People with broken heart syndrome may have sudden chest pain or think they’re having a heart attack.
In broken heart syndrome, there’s a temporary disruption of your heart’s normal pumping function in one area of the heart. The remainder of the heart functions normally or with even more forceful contractions. Broken heart syndrome may be caused by the heart’s reaction to a surge of stress hormones.
The condition may also be called takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy by doctors. The symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in days or weeks.
Symptoms
Broken heart syndrome symptoms can mimic a heart attack. Common symptoms include:
- Chest pain
- Shortness of breath
Causes
The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people.
How these hormones might hurt the heart or whether something else is responsible isn’t completely clear. A temporary constriction of the large or small arteries of the heart has been suspected to play a role.
Broken heart syndrome is often preceded by an intense physical or emotional event. Some potential triggers of broken heart syndrome are:
- News of an unexpected death of a loved one
- A frightening medical diagnosis
- Domestic abuse
- Losing — or even winning — a lot of money
- Strong arguments
- A surprise party
- Having to perform publicly
- Job loss
- Divorce
- Physical stressors, such as an asthma attack, a car accident or major surgery
It’s also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include:
- Epinephrine (EpiPen, EpiPen Jr.), which is used to treat severe allergic reactions or a severe asthma attack
- Duloxetine (Cymbalta), a medication given to treat nerve problems in people with diabetes, or as a treatment for depression
- Venlafaxine (Effexor XR), which is a treatment for depression
- Levothyroxine (Synthroid, Levoxyl), a drug given to people whose thyroid glands don’t work properly
How is broken heart syndrome different from a heart attack?
Heart attacks are generally caused by a complete or near complete blockage of a heart artery. This blockage is due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis) in the wall of the artery. In broken heart syndrome, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.
Risk factors
There are a number of known risk factors for broken heart syndrome, including:
- Sex. The condition affects women far more often than men.
- Age. It appears that most people who have broken heart syndrome are older than 50.
- A history of a neurological condition. People who have neurological disorders, such as a head injury or a seizure disorder (epilepsy) have a greater risk of broken heart syndrome.
- A previous or current psychiatric disorder. If you’ve had disorders, such as anxiety or depression, you probably have a higher risk of broken heart syndrome.
Complications
In rare cases, broken heart syndrome is fatal. However, most who experience broken heart syndrome quickly recover and don’t have long-lasting effects.
Other complications of broken heart syndrome include:
- Backup of fluid into your lungs (pulmonary edema)
- Low blood pressure (hypotension)
- Disruptions in your heartbeat
- Heart failure
It’s also possible that you may have broken heart syndrome again if you have another stressful event. However, the odds of this happening are low.
Treatment
There’s no standard treatment for broken heart syndrome. Treatment is similar to treatment for a heart attack until the diagnosis is clear. Most people stay in the hospital while they recover.
Once it’s clear that broken heart syndrome is the cause of your symptoms, your doctor will likely prescribe heart medications for you to take while you’re in the hospital, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers or diuretics. These medications help reduce the workload on your heart while you recover and may help prevent further attacks.
Many patients make a full recovery within a month or so. Ask your doctor how long you will need to continue taking these medications once you recover, as most can be stopped within three to six months.
Procedures that are often used to treat a heart attack, such as balloon angioplasty and stent placement, or even surgery, aren’t helpful in treating broken heart syndrome. These procedures treat blocked arteries, which are not the cause of broken heart syndrome. But, coronary angiography can be used to diagnose the cause of the chest pain.
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