Tuesday, January 31, 2023

Can You Die From Stress Cardiomyopathy

What Are The Symptoms Of Broken Heart Syndrome

You Can Literally Die From a Broken Heart | Broken Heart Syndrome

You may feel symptoms within minutes up to hours after the stressful event. In broken heart syndrome, the release of stress hormones temporarily stuns your heart muscle, producing symptoms similar to a typical heart attack.

Signs and symptoms of broken heart syndrome include:

  • Sudden, severe chest pain a main symptom.
  • Shortness of breath a main symptom.
  • Weakening of the left ventricle of your heart a main sign.
  • Fluid in your lungs.
  • Irregular heartbeats .
  • Low blood pressure .

A small percentage of patients diagnosed with broken heart syndrome cant identify any stresses that may have triggered their episode.

What To Look For: Signs And Symptoms

The most common signs and symptoms of broken heart syndrome are angina and shortness of breath. You can experience these things even if you have no history of heart disease.

Arrhythmias or cardiogenic shock also may occur with broken heart syndrome. Cardiogenic shock is a condition in which a suddenly weakened heart cant pump enough blood to meet the bodys needs, and it can be fatal if it isnt treated right away. When people die from heart attacks, cardiogenic shock is the most common cause.

Can You Die Of A Broken Heart

Anyone whos suffered a traumatic loss or experienced intense stress understands the toll that grief and emotional strain can take. Doctors say both can also be dangerous for your heart, and for some people during the pandemic especially women they became life-threatening.

Broken-heart syndrome, also known as stress-induced cardiomyopathy, is a real medical condition that can develop after a stressful event a breakup, serious accident or loved ones death or intense emotional stress, such as living through a pandemic. And according to a study published in JAMA Network Open, there was a significant increase in the incidence of stress-induced cardiomyopathy during the COVID-19 pandemic.

While none of the study participants had COVID-19, researchers believe pandemic-related stressors contributed. Living through a pandemic is generally stressful, but added challenges, such as financial worries, increased responsibilities at home, isolation, illness, and loss of loved ones, may have led to the surge in stress-induced heart issues.

How stress affect the bodyWhen the condition strikes, the body releases a surge of stress hormones that stun the left ventricle, which can no longer pump enough blood to the rest of the body. In very rare cases, it can be fatal.

We dont fully understand how stress and grief affect the body, but this is a very real syndrome, says Dr. Hirsch Mehta, a cardiologist affiliated with Sharp Memorial Hospital.

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What Can I Do To Lessen The Risk Of Broken Heart Syndrome

If a person survives the onset of broken heart syndrome, they can often recover within days or weeks, the AHA says. But the long-term effects of the syndrome remain unknown and are being studied. Some research has suggested people who have had broken heart syndrome have a higher risk for future heart events.

We live under such a stressful environment, Cheng said, that she encourages people to “see if you can take steps toward unpacking that stress.”

Some may want grief counseling, which can be provided by employers or community organizations, or therapy. Activities such as yoga, tai chi, other exercise and meditation can help relieve stress.

“We don’t have a medicinal cure for stress,” Cheng said. “But we can try to recognize the loss and how that impacts us as individuals living in those communities, and even remotely. I can tell you, personally, when that story unfolded, I think every single parent I know, regardless of where they lived in the world, was profoundly impacted.”

Amid today’s “incredibly high environmental stress,” she said, “to recognize how that’s impacting us as individuals, as well as our social and our family and household connections, is key.”

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Who Is Gets Broken Heart Syndrome

Broken Heart Syndrome: Can you die from a broken heart?

Broken heart syndrome mostly affects women , especially in later middle age . One possible explanation is that the female hormone estrogen protects the heart against any harmful effects of hormones released in response to stress. As the level of estrogen declines with age, women might be more susceptible to the effects of sudden stress.

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What Is Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy is an uncommon condition that has similar symptoms to a heart attack. Although the cause of takotsubo cardiomyopathy is not completely known, it may happen because of a sudden surge in adrenaline and other stress molecules in your body, possibly due to triggers like severe emotional stress or other health conditions. Experts suspect that because this condition often happens in response to severe physical or emotional stress. People with takotsubo cardiomyopathy typically dont have a major blockage to their hearts arteries, but still have a temporary, often severe, change in hearts pumping ability.

Though it isnt a heart attack, takotsubo cardiomyopathy can still be dangerous. In years past, experts believed takotsubo cardiomyopathy was a temporary condition without long-term risks. While most people who develop this condition will fully recover, they are still at a higher risk for long-term heart problems, as newer research shows this condition increases long-term risk for death or serious health problems compared to people whove had heart attacks.

Can Broken Heart Syndrome Be Prevented

There are no known treatments for preventing broken heart syndrome. However, learning stress management and problem-solving techniques can help improve physical and emotional stress.

Engaging in relaxation techniques can also be helpful. Some examples include:

  • Practicing yoga, meditation, journaling, or mindfulness.
  • Taking a warm bath lighting scented candles and taking long, deep breaths and slowly exhaling.

Depending on the source of your stress, there may be a support group you can join to talk about your stress and share coping skills with others who have had similar experiences. Seeking the help of a professional counselor might be considered too.

In addition, managing physical or emotional stress can be helped by following general healthy habits too. These include:

  • Eating a healthy diet, such as the Dash diet or Mediterranean diet.
  • Getting regular exercise .
  • Getting seven to nine hours of sleep each night.
  • Spending time with others.
  • Keeping your medical appointments, for both follow up and preventive health screenings. Finding and treating any health problems early always leads to the best outcome for a long and healthy life.
  • Avoid or better yet stop unhealthy choices such as smoking, illicit drug use, and alcohol abuse.

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How Do I Take Care Of Myself

If you have takotsubo cardiomyopathy, the best thing to do to take care of yourself is to take your medication and see your doctor as recommended. These are both important because of the long-term risks that come with takotsubo cardiomyopathy, including have a recurrence of the condition or having other health problems months or years after the first event.

What Kinds Of Emotional And Physical Stress Can Cause Broken Heart Syndrome

Stress Cardiomyopathy: Broken Heart, But Does it Mend?

Examples of sudden emotional stressors that can bring on broken heart syndrome include:

  • Grief from the death of a loved one and other large or meaningful loss .
  • Good news .
  • Bad news.

Examples of sudden physical stressors that can bring on broken heart syndrome include:

  • Severe pain.
  • An exhausting physical event.
  • Health issues, including asthma attack, difficulty breathing , seizure, stroke, high fever, low blood sugar , large blood loss, surgery.

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Stress Cardiomyopathy Diagnosis And Treatment

Medina de Chazal H, Del Buono MG, Keyser-Marcus L, et al.
Stress Cardiomyopathy Diagnosis and Treatment: JACC State-of-the-Art Review. J Am Coll Cardiol 2018 72:1955-1971.

The following are summary points to remember from this state-of-the-art review of stress cardiomyopathy:

  • Stress cardiomyopathy is a clinical syndrome characterized by an acute and transient left ventricular systolic dysfunction often related to an emotional or physical stressful event, most often identified in the preceding days .
  • The exact pathophysiology of stress cardiomyopathy remains unclear, but the link between the brain and heart has long been known. An increase in cerebral blood flow in the hippocampus, brainstem, and basal ganglia has been shown in the acute phases. There is a complex neocortical and limbic integration in response to stress through an activation of brainstem noradrenergic neurons and stress-related neuropeptides . In a predisposed individual, who may have enrichment in NPY/norepinephrine granules and risk factors for endothelial dysfunction, an intense stimulation for an adrenergic stimulation may be sufficient to trigger stress cardiomyopathy in response to emotional or physical stress.
  • Clinical Topics:Acute Coronary Syndromes, Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Stress

    The Syndrome Is Often Misdiagnosed As A Heart Attack Because The Symptoms Are Similar

    In addition to chest pain and shortness of breath, patients with broken heart syndrome have electrocardiogram changes that look like a heart attack, Dr. Harmony Reynolds, the director of the Soter Center for Womens Cardiovascular Research at NYU, told INSIDER. But when these patients have an angiogram , they don’t have any blockages or blood clots. “Yet they still have a large area of the heart muscle that doesn’t work properly,” Reynolds told INSIDER.

    Additionally, patients with broken heart syndrome have heart cells that are “stunned” by the adrenaline and stress hormones but not killed as they are in a heart attack, according to John Hopkins Medicine.

    Most patients are able to recover within weeks, although the condition can be life-threatening if patients have congestive heart failure, low blood pressure, shock, or heart rhythm abnormalities, according to John Hopkins Medicine. In either case, it’s important to see a doctor if you experience symptoms.

    “I think there are probably plenty of people who don’t even come to the hospital if they’re having it in the context of an emotional stress,” Reynolds told INSIDER. “It would be a mistake to say ‘Oh this isn’t broken heart syndrome, I’m just upset now’ and to stay home. It’s really important to get to the hospital.”

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    How Does This Condition Affect My Body

    The shape of your heart is critical to how it functions, and if it changes for any reason, that can disrupt your hearts supply of blood and its pumping ability. Every cell in your body relies on the steady supply of oxygen that your blood carries, so it negatively affects your whole body if your heart isn’t pumping effectively.

    Takotsubo cardiomyopathy commonly causes pulmonary edema, which is fluid building up inside your lungs. That makes it harder to breathe, which can be dangerous when its severe. People with this condition may also have cardiogenic shock, which is when the heart cant pump enough blood to meet the demands of the body and other organs may struggle to function. While the tip of the heart is ballooning, some people may develop blood clots in their heart, which increases the risk of stroke until the heart recovers. In rare instances, takotsubo cardiomyopathy can also cause life-threatening heart rhythm problems. Rupture of the hearts lower chambers is also possible but is extremely rare.

    How Does Broken Heart Syndrome Differ From A Heart Attack

    Broken Heart Syndrome

    Most heart attacks occur due to blockages and blood clots forming in the coronary arteries, which supply the heart with blood. If these clots cut off the blood supply to the heart for a long enough time, heart muscle cells will die, leaving the heart with scar tissue and irreversible damage.

    People experiencing broken heart syndrome frequently have normal coronary arteries and often do not have severe blockages or clots. The heart cells of people experiencing broken heart syndrome are stunned by the adrenaline and other stress hormones. Fortunately, this gets better very quickly in most cases, often within weeks or just a few days. Most patients dont have scar tissue or damage.

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    You Can Die Of ‘broken Heart Syndrome’

    Can you die of a broken heart? It can certainly feel that way, and anyone who experiences intense grief after losing a loved one may wonder whether they will survive.

    Dr Alexander Lyon, who is a consultant cardiologist at the Royal Brompton, the specialist heart and lung hospital, is working with researchers at Imperial College to understand why some people die in the few days after a sudden, devastating loss.

    A rush of overwhelming fear or extreme pain are the types of shock he says might also lead to catastrophic heart failure. But it’s not just “bad” emotions that can trigger a condition known as “broken heart syndrome”, Lyon says it could equally be the shock of intense, unexpected happiness, such as winning the lottery.

    The trigger for the syndrome also called stress cardiomyopathy or Takotsubo cardiomyopathy is the body’s sudden, massive release of adrenaline, which can “stun” the bottom half of the main pumping chamber of the heart, in effect paralysing it and requiring the top portion of the chamber to work much harder to compensate.

    Interestingly, survival rates for anyone discharged from hospital having suffered the condition are pretty much 100%. Although, he says, the condition is little known and many of the typical symptoms indicate a standard heart attack caused by a blockage to a coronary artery. This means the patient may be misdiagnosed initially.

    Is Broken Heart Syndrome Dangerous

    Broken heart syndrome can be life threatening. In some cases, it can cause severe heart muscle weakness resulting in:

    • Shock
    • Potentially life-threatening heart rhythm abnormalities

    The good news is that this condition can improve very quickly if patients are under the care of doctors familiar with the syndrome. Even people who are critically ill with this condition tend to recover.

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    Who Are Prone To Stress Cardiomyopathy

    From the available medical literature so far, womenespecially middle aged or elderlyare the most commonly affected. While it can also occur in young women and men, the vast majority of these patients are postmenopausal women.24,25 Indeed, more than 90% of patients suffering from stress cardiomyopathy are females.26 The basis for this predisposition is unknown. Sex hormones exert important influences on the sympathetic neurohormonal axis27 as well as on coronary vasoreactivity,28 but sexrelated differences in catecholamine metabolism and responsiveness are complex and remain poorly understood. Reversible myocardial dysfunction can develop in critically ill patients without any primary heart disease.29 This syndrome is associated with systolic dysfunction, segmental contractile disturbance and electrocardiographic changes.

    Can You Die Of A Broken Heart Science Proves ‘broken Heart Syndrome’ Is Real

    Stress Cardiomyopathy: Medicine Grand Rounds

    Heartbreak can be a devastating experience at any age. When the man I thought was the one ended our relationship years ago, I felt as though I was experiencing a death. I could barely get out of bed, cried more often than not and moped around so miserably my friends grew weary of trying to distract me from my suffering. However, I was lucky my heartbreak wasnt literal.

    Unfortunately, in some peoples cases, a breakup or other traumatic emotional stressor can be enough to cause physical damage to the heart, a syndrome known variously as takotsubo cardiomyopathy, stress-induced cardiomyopathy, or broken heart syndrome.

    The syndrome was first noticed in Japan in 1990, where physicians discovered that people were presenting with the symptoms of a heart attack during initial testing. However, follow-up cardiac angiograms that look for the signature blood clots of a heart attack turned up clean.

    Cardiomyopathy means a weakening of the heart muscle, of the hearts pump, Satjit Bhusri, a cardiologist with Lenox Hill Hospital in New York, told me. Takotsubo is the Japanese term for a kind of pot specially designed to catch octopuses, of all things. When the Japanese researchers who first identified the syndrome examined the hearts of early patients, they saw the same type of appearance as the takotsubo bowl, Bhusri explained. The apex or tip of the heart balloons out, and the base of the heart contracts normally.

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    Heart Attack And Broken Heart Syndrome: Whats The Difference

    Some signs and symptoms of broken heart syndrome differ from those of heart attack. In broken heart syndrome, symptoms occur suddenly after extreme emotional or physical stress. Here are some other differences:

    • EKG results dont look the same as the EKG results for a person having a heart attack.
    • Blood tests show no signs of heart damage.
    • Tests show no signs of blockages in the coronary arteries.
    • Tests show ballooning and unusual movement of the lower left heart chamber .
    • Recovery time is usually within days or weeks, compared with the recovery time of a month or more for a heart attack.

    Broken Heart Syndrome Is A Heart Muscle Failure That Is Usually Caused By A Stressful Event

    The condition, which is brought on by sudden and intense chest pain, can lead to severe, short-term heart muscle failure, according to the American Heart Association. The syndrome occurs when a surge of stress hormones temporarily disrupt pumping in part of the heart. The disruption “stuns” the left ventricle while the rest of the heart continues to function normally, or with even more forceful contractions, according to Harvard Medical School.

    The stress hormones could be triggered by traumatic events such as the death of a loved one, a breakup, physical injury, or by positive events like winning the lottery or being surprised at a party, according to the American Heart Association.

    Individuals with broken heart syndrome typically begin experiencing symptoms anywhere from a couple of minutes to a few hours after the sudden stress, according to John Hopkins Medicine.

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