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Broken heart syndrome

How stress can impact your heart


Editor's note: Sound bites of Dr. Ken Weeks speaking to this topic are available for media. Download 720p version here. Download SD version here. Accompanying b-roll is available here.

Believe it or not, suffering from a broken heart is a real condition.

Broken heart syndrome is a temporary heart condition that's often brought on by stressful situations. The National Institutes of Health says extreme stress can cause the condition, which can lead to heart muscle failure mimicking a heart attack. The medical condition is called takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy.

“Broken heart syndrome is stress induced. It can be brought on by fright, grief, a sudden accident. Frequently, it happens after an aneurysm in the brain where it protects itself with adrenaline.” said Dr. Ken Weeks, a cardiologist at Novant Health Presbyterian Medical Center in Charlotte, North Carolina.     “We all have stress. Under severe and sudden stress, our adrenal glands will release a rush of adrenaline into the blood stream that causes the heart to speed up and work harder and causes a heart attack.”

While the failure of the heart muscle with broken heart syndrome is severe, it is of short duration, and the heart muscle soon returns to normal working function.

“It presents like any other heart attack, except that the heart muscle will assume a very unusual shape that looks like a vessel used to catch squid and octopus in Japan, known as a takotsubo in Japanese,” Weeks said.

Following an episode, most people will be able to go home after two to three days in the hospital, Weeks said. They will be treated with beta blockers, a class of drugs that block adrenaline to help prevent another attack.

Broken heart syndrome isn’t common, but some people appear to be more vulnerable to it. In fact, Weeks said he sees only four to six cases a year. Disproportionately, it strikes women who are often in their early 50s, he said. Many patients are overweight, have diabetes and high blood pressure as well.

The syndrome wasn’t identified until the mid-80s, and Weeks believes that improvements in imaging equipment have allowed cardiologists to see the changes in the heart muscle that are a hallmark of broken heart syndrome.

Broken heart versus a heart attack

“A routine heart attack presents as chest pain, shortness of breath, aching in the arm, sweating. It frequently is related to stress as well, but it is usually caused by a blocked artery.” Weeks said. “The symptoms are similar with broken heart syndrome, but the heart muscle is being damaged particularly badly in the front wall, and it makes a bulge that can be seen with imaging.”

Most heart attacks are caused by blockages in the coronary arteries when clots and blockages in the arteries prevent blood from reaching the heart. When the blood supply to the heart is blocked for a period of time, heart muscle cells will die leaving a heart with permanent damage.

With broken heart syndrome, most people will not have blocked arteries and their heart cells will be “stunned” by elevated stress hormones but not permanently damaged.

“An echocardiogram a few days later will show that the heart attack resolved completely with no evidence that it even occurred,” Weeks said. “It is really peculiar.”

However, since the symptoms are similar, it is imperative that you call 911 if you are experiencing chest pain, shortness of breath and other symptoms related to heart attack. Testing at the emergency department will determine the cause of the attack. Responding quickly can save your life and spare damage to your heart in the case of a heart attack.

Weeks said, when you get to the hospital, be sure to tell emergency personnel if you have experienced extreme stress. The information might help them know what type of event you are having.

A broken heart survivor

In January 2013, Robin Walsh experienced all the classic symptoms of a heart attack. “I felt an overwhelming pressure on my chest, my left arm was throbbing,” said the 58-year-old Monroe, North Carolina, woman.

She called 911 and took a baby aspirin while she waited for medics to arrive. After arriving at Novant Health Presbyterian Medical Center, she was evaluated by cardiologist Dr. Jerome Williams who used imaging to detect that Walsh had broken heart syndrome. He asked Walsh about the stressors in her life.

Walsh said she had been experiencing stress for years. As a result of a car accident involving a Mack truck, she had broken her neck and developed traumatic brain injury. The accident left her “nonfunctional,” she said, to the extent that she couldn’t remember several years of her life.

During that time, Walsh was unable to work and, as a single mother of a high school-age son, was feeling a huge financial burden.

Following her diagnosis of broken heart syndrome, Walsh said she has changed her lifestyle to better manage her stress. “I sold everything, got a roommate and now work part-time as a home health assistant,” she said. “I just don’t feel as burdened.”

Walsh wanted to share her story to help raise awareness about the effects of stress on your heart.





Published: 9/12/2016