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Broken Heart Syndrome

Tariq Abo-Elfotouh

Verywell / Brianna Gilmartin


Broken heart syndrome is a temporary heart condition that's often brought on by stressful situations and extreme emotions. The condition can also be triggered by serious physical illness or surgery. Other names; stress cardiomyopathy, Takotsubo carrdiomyopathy or apical ballooning syndrome.


People with broken heart syndrome may have sudden chest pain or think they're having a heart attack as it affects just part of the heart, temporarily disrupting the heart's normal pumping function while the heart continues to function normally or may even have more forceful contractions.


The symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in days or weeks.


Symptoms

Broken heart syndrome symptoms can mimic a heart attack. Common symptoms include; chest pain, shortness of breath and any long-lasting or persistent chest pain could be a sign of a heart attack, so it's important to take it seriously.


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 with an unknown mechanism.


A temporary constriction of the large or small arteries of the heart has been suspected to play a role. People who have broken heart syndrome may also have a difference in the structure of the heart muscle.


Broken heart syndrome is often preceded by an intense physical or emotional event.

Some potential triggers of broken heart syndrome are:

- The death of a loved one

- A frightening medical diagnosis

- Domestic abuse

- Losing — or even winning — a lot of money

- Strong arguments

- A surprise party

- Public speaking

- Job loss or financial difficulty

- Divorce

- Physical stressors, such as an asthma attack, COVID-19 infection, a broken bone or major surgery

- Drugs like; Epinephrine (EpiPen, EpiPen Jr.), Duloxetine (Cymbalta), Venlafaxine (Effexor XR) as well as unprescribed or illegal stimulants, such as methamphetamine and cocaine.


Differences between Broken Heart Syndrome and 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.


Treatment

Initially treated like a heart attack, however once a diagnosis is made, broken heart syndrome is treated with medicines such as ACE inhibitors to lower blood pressure, beta blockers to slow the heart rate, diuretics to decrease fluid buildup, and anti-anxiety medicines to manage stress.


Treatments such as angioplasty, stent placement, and surgery are used to treat a heart attack but are NOT used in cases of broken heart syndrome because they address the problem of blocked arteries, which is not found in broken heart syndrome.


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 also may help prevent broken heart syndrome, though there's currently no evidence to prove this.


References

1- Mahajani V, Suratkal V. Broken Heart Syndrome. J Assoc Physicians India. 2016 Jun;64(6):60-63. PMID: 27739268.


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