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A stressful event, such as the death of a loved one, can really break your heart. In medicine, the disease is known as broken heart syndrome or takotsubo syndrome. It is characterized by a temporary disruption of the normal pumping function of the heart, which increases the risk of death. This is the reason why many older couples die soon after.
Broken heart syndrome has symptoms similar to those of a heart attack, including chest pain and breathing difficulties. During a crisis that can be triggered by grief, divorce, surgery or other stressful event, the heart muscle weakens to the point that it can no longer pump blood effectively.
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In about one in ten cases, people with broken heart syndrome develop a condition called cardiogenic shock, which prevents the heart from pumping enough blood to meet the needs of the body. This can lead to death.
Physical damage
It has long been thought that, unlike a heart attack, the lesions caused by broken heart syndrome were temporary and lasted days or weeks, but recent research suggests that this is not the case.
A study by researchers at the University of Aberdeen provided the first evidence that broken heart syndrome results in permanent physiological changes to the heart. The researchers followed 52 patients with this condition for four months, using ultrasound and cardiac imaging to closely examine the functioning of their heart. They discovered that the disease permanently affected the pumping movement of the heart. They also found that some parts of the heart muscle were replaced by thin scars, which reduced the elasticity of the heart and prevented it from contracting properly.
In a recent follow-up study, the same research team reported that people with broken heart syndrome had persistent heart failure and reduced exercise capacity, resembling heart failure, for more than 12 months after their exit from the hospital.
Long term risk
A new study on the disease, published in Circulation, now shows that the risk of death remains high several years after the initial attack.
In this study, Swiss researchers compared 198 patients with a broken heart syndrome who developed cardiogenic shock to 1,880 patients who did not experience cardiac shock. They found that patients with cardiogenic shock were more likely to have the syndrome triggered by physical stress, such as a surgery or an asthma attack, and that they were also far more likely to have died five years after the initial event.
People with significant risk factors for heart disease, such as diabetes and smoking, were also much more likely to experience cardiogenic shock, just as people with atrial fibrillation (a type of arrhythmia heart).
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A second study in Spain found similar results in 711 people with broken heart syndrome, 11% of whom developed cardiogenic shock. Over the course of a year, cardiogenic shock was the most powerful predictor of death in this group of patients.
These studies show that cardiogenic shock is not an unusual risk factor in patients with broken heart syndrome and that it is a powerful predictor of death. They brought to light an illness that was originally thought to be less serious than it was.
The evidence now clearly shows that the disease is not temporary and highlights the urgent need for more effective new treatments and close monitoring of people with this disease.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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