How Common Is 'Broken Heart Syndrome'?
Study Suggests Men as Well as Women Have Condition That's Also Known as Stress Cardiomyopathy
Documenting Broken Heart Syndrome continued...
For 30%, the cause was emotional, and included the death of a friend, pet, or relative, interpersonal conflict, anxiety, anger, or the loss of a job.
For 41% of study participants, the cause was physical. Top physical stressors reported in the study included surgery, breathing trouble like COPD, asthma, or bronchitis, and chemotherapy.
"Despite careful history taking," the researchers write, "only two-thirds of patients had a clearly identifiable preceding stressor."
"Thus, our large multi-center cohort demonstrates that the absence of an identifiable stressful event does not rule out the diagnosis," they conclude, and surmise that the mysterious disorder may have complex underpinnings, involving the endocrine, vascular, and central nervous systems. This suggests the need for enhanced awareness and recognition of this condition to ensure correct diagnosis and management.
How Stress Cripples the Heart
Stress cardiomyopathy is thought to be at work in as many as 2% of people who are admitted to the hospital for a heart attack. Among women, that number is even higher, accounting for as many as 5% to 7% of those with suspected heart attacks, Wittstein says.
Though the mechanism isn't clear, researchers say it looks as though a surge in stress hormones causes blood vessels around the heart to constrict.
"When the very tiny blood vessels, the microvascular circulation, when that is affected, it can cause a temporary decrease in blood flow to the heart and cause a temporary stunning of the heart muscle," Wittstein says.
But unlike a heart attack, where heart cells actually die and there's scar tissue left, with stress cardiomyopathy, the heart muscle cells are temporarily stunned, but not irreversibly damaged.
"The heart muscle can look very weak at the time of [hospital] arrival, but it recovers completely," he says.
Most patients in the study presented with classic heart attack symptoms like chest pain and shortness of breath, but others were evaluated after they fainted or their heart suddenly stopped beating.
A few patients were admitted to the hospital after doctors suspected heart problems during other kinds of routine procedures.
All study participants had coronary angiograms, minimally invasive procedures that allow doctors to look for blocked arteries around the heart that may have caused a heart attack.