Cardiology

Dying Of A Broken Heart

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        [name] => Dr Julian Tan
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        [address] => Julian Tan Heart Specialist Clinic Pte Ltd
    
    3 Mount Elizabeth
    #14-09/10 Mount Elizabeth Medical Centre
    Singapore 228510
    
    The Cardiology Practice
    
    1 Farrer Park Station Road
    #08-01 Connexion
    Singapore 217562
    
    Tel: 6235 8733
    www.juliantanheart.com
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  • April 1, 2019
  • 1 minute read

The condition is not just a poetic metaphor — intense emotion can cause what’s colloquially known as broken heart syndrome. This happened to movie legend Debbie Reynolds, who died a day after her daughter, Carrie Fisher, passed on — and threw the spotlight on a condition called stress-induced cardiomyopathy, also referred to as broken heart syndrome or takotsubo syndrome (TTS). The latter, Japanese for “octopus trap”, describes the shape of the left ventricle of the heart when it weakens.

What cause TTS?

TTS is believed to happen when stress hormones, such as adrenaline, temporarily disrupt the function of the left ventricle. These hormones cause changes in heart muscle cells and/or coronary blood vessels that prevent the left ventricle from contracting effectively. TTS is typically brought on by intense stress, serious physical illness or surgery. It can also be triggered by strong emotions on the other end of the spectrum — researchers have found evidence that extreme happiness and sadness share common emotional pathways. These strong emotions overstimulate the sympathetic nervous system, resulting in a cardiovascular reaction. Certain drugs that induce a release of adrenaline or other stress hormones may also lead to TTS. Other risk factors for TTS include:

  • Gender: the condition affects more women than men
  • Age: it usually appears in people older than 50 years
  • Medical history: at higher risk are people with existing neurological disorders (eg: epilepsy) and psychological disorders (eg: anxiety, depression), as well as those who have suffered head trauma

What are the symptoms?

The symptoms of TTS include chest pain and shortness of breath — can often be mistaken for a heart attack. But unlike heart attack, the heart arteries are not blocked. However, the stress-induced weakness of the heart reduces the blood flow in the arteries.

Is it treatable?

The symptoms of broken heart syndrome are treatable and the condition usually reverses itself in days or weeks. Typically, treatment is similar to that for a heart attack. You may be prescribed heart medications to reduce the stress on your heart. There’s a small chance that the condition can recur: there is no proven therapy to prevent additional episodes.

Whatever the case, if you experience persistent chest pain, seek emergency medical attention. This is critical to rule out an actual heart attack and prevent complications such as:

  • the backing-up of fluid into the lungs (pulmonary oedema)
  • low blood pressure (hypotension)
  • irregular heartbeat
  • heart failure
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