Stress Cardiomyopathy: Exploring Broken Heart Syndrome
Broken heart syndrome, also known as stress cardiomyopathy or Takotsubo cardiomyopathy, is a heart condition that can be caused by a stressful life event or extreme emotions. Scientists believe that the release of stress hormones may cause a sudden dysfunction of the heart’s left ventricle. This is usually temporary, although in some cases, a person who experiences this event may continue to feel poorly even after the damage has healed.
In recent years, researchers have discovered that broken heart syndrome can be linked to positive stressful events, such as the birth of a baby or a wedding. In these cases, professionals may refer to the phenomenon as “happy heart syndrome.” It can be important to effectively address stress and extreme emotions so that they don’t have lasting negative impacts on your well-being. One way to do so may be to work with a licensed therapist in person or online.
Takotsubo cardiomyopathy: Symptoms of broken heart syndrome
The symptoms of broken heart syndrome are often mistaken for those of a heart attack. They typically include the following:
Chest pain or heaviness
Shortness of breath
Irregular or rapid heartbeat
Dizziness or fatigue due to low blood pressure or restricted blood flow
A sudden weakness in your heart muscle
As the body’s coping mechanism to stress, it releases adrenaline and noradrenaline hormones. The sudden surge of adrenaline in response to stress overwhelms the heart muscle and causes sudden chest pain. This reduces blood flow to the heart as small arteries constrict from excess adrenaline.
Potential complications of stress cardiomyopathy
While broken heart syndrome is usually temporary, there are some cases in which it can recur. Some potential complications of this condition may include those listed below:
Blood clots in the coronary arteries
Low blood pressure
Pulmonary edema
Irregular heartbeat
Heart failure
Broken heart syndrome vs. heart attack: Identifying potential sources of chest pain
While the symptoms of these conditions may mirror one another, the underlying causes are usually quite different. Broken heart syndrome may not be as severe because the arteries do not become blocked, and death from this condition tends to be rare. However, if you experience the symptoms associated with broken heart syndrome, it may be essential to seek emergency medical attention to determine whether you’re having a heart attack.
Causes of broken heart syndrome
While researchers are unclear on the exact cause of broken heart syndrome, they believe it has something to do with a surge of stress hormones like adrenaline, which can temporarily damage the heart. This hormone surge may trigger changes in the heart muscle cells, the coronary arteries, or both, and this can prevent the effective contraction of the left ventricle.
How grief and sadness from loss can cause emotional and physical stress
What typically happens is that an event causes severe emotional stress, physical stress, or both, and there is a temporary squeezing of the large or small arteries in the heart. The structure of the heart may also change in more severe reactions. Some events that may lead to broken heart syndrome include the following:
A broken bone
An emotional argument
Major surgery
Sudden illness, like an asthma attack
The death of a loved one
Witnessing violence
The use of certain medications (for allergies and asthma particularly) and illegal stimulants, such as cocaine or methamphetamines
Risk factors for developing takotsubo cardiomyopathy
A few factors may put you at greater risk for developing broken heart syndrome.
Those assigned female at birth tend to be more prone to developing broken heart syndrome.
Individuals with conditions like anxiety disorders or depression may be at higher risk.
Broken heart syndrome is most frequently observed in people over 50 years old.
Treatment for broken heart syndrome
A physician can determine whether you have experienced broken heart syndrome by observing an electrocardiogram (EKG) to determine heart electrical abnormalities, completing cardiac catheterization to ensure arteries are not blocked, and running an echocardiogram to check for any weakness or strain on the heart muscle.
There’s no standard treatment for broken heart syndrome
Once an individual has been diagnosed with broken heart syndrome, a doctor may prescribe ACE inhibitors or beta blockers, which are medications typically used for heart failure. Recovery can take up to a few weeks, with some individuals engaging in cardiac rehabilitation programs during this time.
For some patients, a medical professional may further recommend therapy to manage anxiety or stress. Evidence-based talk therapy approaches like cognitive behavioral therapy (CBT) can help manage fears around the experience, as well as offer tools and strategies to manage future stress. CBT can be an effective way to decrease anxiety symptoms.
For those recovering from broken heart syndrome, attending online therapy sessions may be an easier way to receive therapy. With doctors’ appointments, cardiac rehab, and a need for rest after their experience, talking to a therapist from their own home may be the most convenient solution to get help with stress and anxiety.
Research has shown that online therapy can be just as effective as in-person therapy, so those who have experienced broken heart syndrome may rest assured that they may receive the same high-quality care whether they attend therapy online or in person.
How you can help prevent broken heart syndrome
In many cases, emotional or physical stress seems to be the root cause of broken heart syndrome. A common risk factor for developing this condition may be chronic stress. There are some ways you can manage stress in your life, in addition to therapy. These include implementing healthy lifestyle habits like those discussed below.
Engage in physical activity
Getting moderate intensity exercise for an hour a day on most days of the week can lower stress levels, and exercise may have the added benefits of lowering blood pressure and promoting cardiovascular health.
Exercise doesn’t have to be any one particular activity. Instead, you can experiment to find what you most enjoy. Walking, hiking, taking a group fitness class, and playing with your kids or grandkids are just a few options. If you have already experienced broken heart syndrome or have other health problems, talk to your doctor before starting an exercise plan.
Make social connections
One of the most effective ways to defend yourself against the effects of stress can be to have a strong social safety net. This can include family, close friends, or groups of people with similar hobbies and interests. Support groups can also be a helpful way to connect with others if you are having difficulty finding a friend group.
Getty/Israel Sebastian
Create a mindfulness practice
It can be easy to neglect your emotional health when surrounded by work, home, and life obligations. Mindfulness practices can serve as a way to bring your mind into the present moment and give yourself a break. Below are several ways to incorporate mindfulness into your day:
Journaling
Taking breaks to stretch and breathe deeply
Practicing yoga
Meditating
Going outside
Takeaway
The symptoms of broken heart syndrome may seem scary because they can be very similar to those of a heart attack, but there is rarely any lasting damage. Defensive measures against physical and emotional stress, such as online or in-person therapy and various lifestyle adjustments, can be helpful in avoiding the development or recurrence of this medical condition. It can also be important to get medical help if you have chest pain or shortness of breath so a medical professional can rule out a heart attack.
Can you have a heart attack with broken heart syndrome?
Takotsubo syndrome, or “broken heart syndrome,” is not the same thing as a heart attack, but they can cause similar symptoms:
Broken heart syndrome symptoms may include things like chest pain or tightness, sweating, shortness of breath, dizziness, irregular heartbeats (arrhythmia), nausea, or fatigue. Broken heart syndrome is caused by physical or emotional stress that overwhelms heart cells.
Heart attacks can cause different symptoms based on sex assigned at birth, but they may include chest pain or pressure, pain that comes and goes or spreads to other parts of the body, jaw or neck pain, shortness of breath, weakness, lightheadedness, heartburn, nausea, upper back pain, anxiety, coughing, or cold sweating. Heart attacks are usually caused by blocked arteries that limit blood flow to the heart.
Because symptoms can be so similar, it’s important to get evaluated by a medical practitioner. Medical practitioners will typically evaluate symptoms with a physical exam, blood tests, electrocardiogram (ECG) monitoring, and echocardiogram imaging.
In some rare cases, severe broken heart syndrome can cause heart muscle weakness that triggers dangerously low blood pressure, shock, severe heart rhythm issues, or congestive heart failure.
Can you recover from stress cardiomyopathy?
Yes, it’s often possible to recover from stress cardiomyopathy, also called broken heart syndrome, with a combination of medications, lifestyle modifications, relaxation techniques, talk therapy, and social support. In some cases, broken heart syndrome complications can be serious, so it’s important to seek medical care.
Many people wonder, “Is broken heart syndrome real?” According to medical practitioners, it is real, causing physical effects after experiencing overwhelming emotional and/or physical stress, such as grief, a car accident, or a high fever. These major stressors can produce an overwhelming quantity of adrenaline and other stress hormones that can temporarily narrow arteries and reduce blood flow to the heart. Additionally, stress can directly disrupt calcium levels that regulate the heartbeat. These hormones cause temporary, but usually reversible, heart muscle weakness.
Note that while broken heart syndrome is often caused by a stressful event, in around 30% of cases, there is no identifiable stressor initiating symptoms.
How long does chest pain from broken heart syndrome last?
Stress-induced cardiomyopathy, or “broken heart syndrome,” typically comes on suddenly and resolves within a few days to weeks, with the heart usually healing fully within a month of experiencing an extremely stressful event.
Can sadness, grief, or emotional pain cause broken heart syndrome?
Broken heart syndrome, also called stress-induced cardiomyopathy or apical ballooning syndrome, can be caused by physical or emotional stress, including the following:
A physically stressful event, such as a serious illness, high fever, severe asthma attacks, use of illegal stimulant drugs, or surgery
A highly emotional event, like trauma, grief, argument, or receiving bad news
Broken heart syndrome may cause heart attack-like symptoms, making it important to seek emergency care if you experience new or unexpected chest pain, shortness of breath, or an irregular heartbeat.
Broken heart syndrome treatment may include the prescription of emergency medicines, exercise, relaxation exercises, and routine heart health screening. Most people make a full recovery after experiencing broken heart syndrome, and it’s unlikely for them to experience it recurrently.
Can memory loss happen when someone experiences sudden acute stress?
Yes, a sudden stressful event may lead to acute memory less. This happens because sudden stress can release hormones that trigger a flight-or-fight response that disrupts normal memory formation. This explains why some people have trouble fully recalling traumatic or extremely stressful events.
How can broken heart syndrome cause a sudden weakness in your heart muscle?
Broken heart syndrome is caused by a sudden surge of stress hormones, like adrenaline, which overwhelm the heart muscle. This can lead to temporary weakening of the heart muscle which triggers broken heart syndrome symptoms.
Recovery from broken heart syndrome differs from person to person, but most people recover within a few days to weeks.
What is the main symptom of broken heart syndrome?
The primary symptoms of broken heart syndrome include shortness of breath and chest pain. These symptoms can mimic those of a heart attack and it’s important to seek emergency medical care if you experience them.
Can you fully recover from broken heart syndrome?
Broken heart syndrome causes a temporary weakening of the heart muscle, but most people make a full recovery. Treatments like medications and temporary hospitalization can help recovery. From there, it’s typically recommended that people work to manage physical and emotional stressors with strategies like healthy eating, talk therapy, and/or quitting substance use.
What is the main cause of broken heart syndrome?
The main cause of broken heart syndrome is a physical or emotional stressor that causes a sudden release of stress hormones, particularly adrenaline. Some examples of situations that may lead to broken heart syndrome include surviving a traumatic event, a heated argument, grief, a high fever, heavy lifting, serious blood loss, or an overwhelmingly positive event, like winning the lottery.
Because it’s colloquially called broken heart syndrome, some people ask questions like, “Is broken heart syndrome real or is it just a figure of speech?” According to medical practitioners, it’s a real diagnosis that can be life-threatening. Within the medical field, it’s usually called “Takotsubo cardiomyopathy” or “apical ballooning syndrome.”
What is the survival rate for broken heart syndrome?
The vast majority of people recover from broken heart syndrome; however, it’s estimated that 0%-8% of patients may die from the condition. In one study, 519 patients with broken heart syndrome were followed for 5.2 years. The researchers found that in that time, 7.5% of patients had recurrent episodes of broken heart syndrome, and 16.2% had died. Medications like beta-blockers resulted in a reduced risk of recurrence or death.
How do you tell if you have a broken heart syndrome?
Are you wondering, “How is broken heart syndrome diagnosed?” You’re not alone.
Most medical professionals will take a medical history and run several tests, including blood tests, heart imaging via sound waves (echocardiogram), coronary angiograms, electrocardiograms that monitor electrical activity, and/or a cardiac MRI. These tests are usually used to rule out other issues with similar symptoms, like heart disease, a heart attack, or even low blood sugar.
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