Broken Heart Syndrome – Symptoms, Diagnosis, Treatment

What is Broken Heart Syndrome?

There are a lot of fictional stories depicting characters who die after suffering a devastating loss purely from grief. In reality, however, people do not commonly die from a broken heart, although it can be a scary experience and feel life-threatening. A broken heart is usually a metaphor describing strong emotional suffering and pain. Most commonly it is caused by a loss of a loved one through death, break-up, divorce, romantic rejection, separation, betrayal, or any physical separation.

Broken heart syndrome is the root cause of a death for a person grieving the loss of a dead spouse, although the main cause has not been proven. The condition is caused by sudden emotional stress due to traumatic break-up, death, or any other related stressor. This condition does not imply physical defect or deformities in the heart, but the certain traumatizing incident causes the brain to release chemicals that eventually weakens the heart tissue. Broken heart syndrome is different compared to a heart attack, as the patient’s heart is clinically healthy in comparison to patients experiencing a heart attack. Studies shows that recovery periods of patients with Broken Heart Syndrome are more rapid, compared to those who experience a heart attack. Complete recovery can be achieved over a fortnight if the right treatment is put in place.

Broken heart syndrome is a temporary heart condition where stress hormones are rapidly released. Part of the heart is temporarily enlarged causing the heart not to pump well. However, the other parts of the heart continue to function normally or in some cases, forcefully contracting. The condition was formerly known as Takotsubo Cardiomyopathy, also as stress cardiomyopathy, apical-ballooning syndrome, or stress-induced cardiomyopathy.

Symptoms

Symptoms are treatable and one can recover in a week. The symptoms mimic a heart attack. Symptoms include:

• Chest pain
• Arrhythmia
• Shortness of breath
• Generalized weakness

Remember to see a doctor when experiencing chest pain, rapid heartbeat, or shortness of breath after a stressful event. Persistent chest pain can be a sign of a heart attack. See a doctor immediately.

Causes

The exact cause is unclear. However some theories suggest that hormones such as adrenaline temporarily damage the heart, but the exact reason is unclear. Temporary constriction of arteries, whether large or small, plays a role. This disease is often preceded by an intense emotional or physical event. Some potential triggers are:

• Unexpected death of a loved one
• Frightening medical diagnosis
• Domestic violence and abuse
• Surprise party
• Financial constraints
• Public performance
• Physical stressors: Infection, asthma attack, major surgery, or car accident.

How is it different from a heart attack?

Heart attacks are commonly caused by blockage of a heart artery whether complete or incomplete. The blockage is caused by a blood clot formed on the site and then narrowing, due to fat build-up in the arterial walls. In cases of Broken Heart Syndrome, the arteries of the heart are not blocked, but there is a reduction in blood flow.

Risk Factors

Broken Heart Syndrome affects women more than men. Often, cases include women who are aged 50 or older.

Tests and Diagnosis

If you suspect you have a broken heart syndrome, the following examinations and tests are required to complete the diagnosis:

• Physical examination and personal history—In addition to the typical physical examinations, a medical history will be taken, especially for those who have experienced symptoms of a heart disease. Diagnosed individuals with broken heart syndrome typically do not have symptoms of any heart disease prior to diagnosis of broken heart syndrome. Also, the physician will question you regarding major emotional stressors such as the loss of a loved one.
• ECG (Electrocardiogram)—this is a noninvasive test in which health care practitioners will place wires on your chest and will record the electrical impulses of your heart beat. The test records these signals and helps your doctor detect irregularities in the structure and rhythm of your heart.
• CXR (Chest X-Ray)—An X-ray will be required to check for any enlargement of the heart. Also, it will be used to check if the heart is shaped according to those hearts diagnosed with broken heart syndrome. Lungs will also be checked if it is the root cause of your symptoms.
• Echocardiogram—an echocardiogram may be used to check if there is enlargement of the heart as well as if there is presence of any abnormal shape. This noninvasive examination includes a chest ultrasound to indicate detailed images of the heart’s structure as well as its function. Transmission of ultrasound waves will be seen and the sounds will be recorded via transducer that is held outside the body. Moving images of the heart are seen on a video monitor.
• Blood tests—certain blood tests, such as enzyme testing, to check the presence of abnormally high-level of enzymes to confirm the diagnosis of broken heart syndrome. Most individuals having broken heart syndrome have elevated levels of the specific enzyme.

Treatment

No standard treatment guidelines are present for the treatment of broken heart syndrome. Usually, treatment is similar to those experiencing heart attacks until a concrete diagnosis is formed. Most treatments require individuals to stay in the hospital while recovering. Once the diagnosis for broken heart syndrome is confirmed, the physician will prescribe medications for your heart during your stay in the hospital. ACE (Angiotensin-converting enzyme) inhibitors, certain diuretics, and beta-blockers will be prescribed to reduce the heart’s workload while recovering. It also prevents further attacks. Full recovery is common after one or two months. Specific length of taking the medication varies for every patient.

Invasive procedures such as stent replacement, Balloon angioplasty, or surgery, are not helpful for the treatment of broken heart syndrome. Specific procedures such as these are indicated for treatment for specific arteries that are blocked, which is not the root cause of broken heart syndrome, thus unnecessary. However, coronary angiography is most often used to diagnose the exact cause of the chest pain.

Complications

There are rare cases in which a broken heart syndrome turns fatal. However, it is more common for people who experience broken heart syndrome to recover quickly along with an absence of long-lasting negative side-effects.

Other complications may include:

• Tachycardia or Bradycardia
• Heartbeat disruptions
• Pulmonary edema—fluid goes back to the lungs and stays there
• Recurrence of broken heart syndrome—due to another stressful event

Prevention

There is a chance of recurrence of broken heart syndrome after an episode. Currently, there is no proven treatment for prevention. However, physicians recommend treatment that lasts longer than usual such as taking up beta-blockers or similar medications that block the damaging effects of the specific stress hormones that damages the heart. Stress management also plays a big role in prevention of broken heart syndrome.