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News from Sierra Nevada Memorial Hospital and Hospital Foundation

 

Those that have fallen in love may not realize there are “feel good” chemicals the body produces. After a breakup or the death of a loved one, the brain stops generating these chemicals, and the body suffers from withdrawal of these feel-good hormones. When this happens, it can cause withdrawal, depression, or for some, can be painful.

For some, this condition is known as Broken Heart Syndrome (BHS), stress cardiomyopathy, or takotsubo cardiomyopathy. Takotsubo is a Japanese name for an octopus trapping pot with a wide bottom and narrow neck. The neck resembles the shape of a distressed left ventricle of the heart seen in BHS.

BHS, a rapid weakening of the heart, is temporary and reversible. Many people experiencing BHS think they are having a heart attack because symptoms such as shortness of breath and chest pain are similar in both conditions. However, BHS doesn’t involve blocked coronary arteries and does not cause permanent heart damage.



While symptoms generally mimic a heart attack, it is caused by sudden physical and emotional stress. Emotional stressors include grieving over the death of a loved one or intense fear caused by anything from public speaking, to being the victim of a crime. Anger can also trigger BHS in situations such as road rage, being involved in a physical altercation, or a tragic car accident.

Physical stressors vary and can include an exhausting physical event, severe pain, or chronic health issues such as an asthma attack, dyspnea (difficulty breathing), seizures, and strokes.




Approximately two percent of patients that present with a suspected heart attack are experiencing BHS. It is predominant in women (88%) in later middle-age, generally after menopause. One theory is that estrogen (a female hormone) protects the heart against harmful effects of hormone release in response to stress. As the level of estrogen declines, generally between ages 58 to 77, women may become more susceptible to high levels of stress.

When suffering from BHS, the steady rhythm of the heart muscle is disrupted. Sometimes the lower part of the ventricle enlarges temporarily. It can also lead to forceful contractions in other areas of the heart.

Can someone die of BHS? While complications are rare, they can include a rupture or blockage of blood flow of the left ventricle, heart failure, and cardiogenic shock. Although it is not impossible, about one percent of cases result in death.

Treatment varies depending on severity, although it is generally treated with medications. Your physician may prescribe ACE inhibitors to lower blood pressure, beta blockers to slow heart rate, or diuretics to decrease fluid buildup. Where stress is extreme, anti-anxiety medicines may be a path toward recovery.

For those whose heart muscle has been seriously impacted, cardiac rehabilitation may be recommended. Some people opt for self-care such as yoga, meditation, and other relaxation techniques. Only about five percent of people have more than one episode of BHS. Most cases will clear up in one to four weeks with full recovery within two months.


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