Disease: Broken heart syndrome

Overview

Broken heart syndrome is a temporary heart condition that's often brought on by stressful situations, such as the death of a loved one. The condition can also be triggered by a serious physical illness or surgery. People with broken heart syndrome may have sudden chest pain or think they're having a heart attack.

In broken heart syndrome, there's a temporary disruption of your heart's normal pumping function in one area of the heart. The remainder of the heart functions normally or with even more forceful contractions. Broken heart syndrome may be caused by the heart's reaction to a surge of stress hormones.

The condition may also be called takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy by doctors. The symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in days or weeks.

Source: http://www.mayoclinic.com

Symptoms

Broken heart syndrome symptoms can mimic a heart attack. Common symptoms include:

  • Chest pain
  • Shortness of breath

Any long-lasting or persistent chest pain could be a sign of a heart attack, so it's important to take it seriously and call 911 if you experience chest pain.

When to see a doctor

If you're having any chest pain, a very rapid or irregular heartbeat, or shortness of breath after a stressful event, call 911 or emergency medical assistance immediately.

Source: http://www.mayoclinic.com

Causes

The exact cause of broken heart syndrome is unclear. It's thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people.

How these hormones might hurt the heart or whether something else is responsible isn't completely clear. A temporary constriction of the large or small arteries of the heart has been suspected to play a role.

Broken heart syndrome is often preceded by an intense physical or emotional event. Some potential triggers of broken heart syndrome are:

  • News of an unexpected death of a loved one
  • A frightening medical diagnosis
  • Domestic abuse
  • Losing — or even winning — a lot of money
  • Strong arguments
  • A surprise party
  • Having to perform publicly
  • Job loss
  • Divorce
  • Physical stressors, such as an asthma attack, a car accident or major surgery

It's also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include:

  • Epinephrine (EpiPen, EpiPen Jr.), which is used to treat severe allergic reactions or a severe asthma attack
  • Duloxetine (Cymbalta), a medication given to treat nerve problems in people with diabetes, or as a treatment for depression
  • Venlafaxine (Effexor XR), which is a treatment for depression
  • Levothyroxine (Synthroid, Levoxyl), a drug given to people whose thyroid glands don't work properly

How is broken heart syndrome different from a heart attack?

Heart attacks are generally caused by a complete or near complete blockage of a heart artery. This blockage is due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis) in the wall of the artery. In broken heart syndrome, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.

Source: http://www.mayoclinic.com

Diagnosis

If your doctor suspects you have broken heart syndrome, he or she will use these exams and tests to make a diagnosis:

  • Personal history and physical exam. In addition to a standard physical exam, your doctor will want to know about your medical history, especially whether you've ever had heart disease symptoms. People who have broken heart syndrome usually don't have any heart disease symptoms before they're diagnosed with broken heart syndrome. Also, your doctor will want to know if you've experienced any major stresses recently, such as the death of a loved one.
  • Electrocardiogram (ECG). In this noninvasive test, a technician will place wires on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor detect irregularities in your heart's rhythm and structure.
  • Echocardiogram. Your doctor may also order an echocardiogram to see if your heart is enlarged or has an abnormal shape, a sign of broken heart syndrome. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function.

    Ultrasound waves are transmitted, and their echoes are recorded with a device called a transducer that's held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.

  • Blood tests. Most people who have broken heart syndrome have an increased amount of certain enzymes in their blood. Your doctor may order blood tests to check for these enzymes to help diagnose broken heart syndrome.
  • Chest X-ray. Your doctor will likely order a chest X-ray of your chest to see if your heart is enlarged or has the shape that's typical of broken heart syndrome, or to see if there are any problems in your lungs that could be causing your symptoms.
  • Cardiac magnetic resonance imaging (MRI). For this test, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field produces detailed pictures to help your doctor evaluate your heart.
  • Coronary angiogram. During a coronary angiogram, a type of dye that's visible by X-ray machine is injected into the blood vessels of your heart. Then, an X-ray machine rapidly takes a series of images (angiograms) that give your doctor a detailed look at the inside of your blood vessels.

    Because broken heart syndrome often mimics the signs and symptoms of a heart attack, a coronary angiogram may be done quickly to rule out a heart attack. People with broken heart syndrome often don't have any blockages in the blood vessels, while people who've had a heart attack usually have a blockage that is visible on an angiogram.

    Once it's clear you're not having a heart attack, your doctor will check to see if your signs and symptoms were caused by broken heart syndrome.

Source: http://www.mayoclinic.com

Complications

In rare cases, broken heart syndrome is fatal. However, most who experience broken heart syndrome quickly recover and don't have long-lasting effects.

Other complications of broken heart syndrome include:

  • Backup of fluid into your lungs (pulmonary edema)
  • Low blood pressure (hypotension)
  • Disruptions in your heartbeat
  • Heart failure

It's also possible that you may have broken heart syndrome again if you have another stressful event. However, the odds of this happening are low.

Source: http://www.mayoclinic.com

Prevention

There's a small chance that broken heart syndrome can happen again after a first episode. There's no proven therapy to prevent additional episodes.

Many doctors recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart. Recognizing and managing stress in your life may also be important in helping to prevent broken heart syndrome, though there's currently no evidence to prove this.

Source: http://www.mayoclinic.com

Risk factors

There are a number of known risk factors for broken heart syndrome, including:

  • Sex. The condition affects women far more often than men.
  • Age. It appears that most people who have broken heart syndrome are older than 50.
  • A history of a neurological condition. People who have neurological disorders, such as a head injury or a seizure disorder (epilepsy) have a greater risk of broken heart syndrome.
  • A previous or current psychiatric disorder. If you've had disorders, such as anxiety or depression, you probably have a higher risk of broken heart syndrome.

Source: http://www.mayoclinic.com

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