Broken heart syndrome

Broken heart syndrome is a temporary heart condition that is 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 are having a heart attack.

In broken heart syndrome, there is a temporary disruption of 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 symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in days or weeks.

Symptoms

Common symptoms include:

•             Chest pain

•             Shortness of breath

Any long-lasting or persistent chest pain could be sign of a heart attack, so it is important to take it seriously. If you are having any chest pain, a very rapid or irregular heartbeat, or shortness of breath after a stressful event, you need  medical assistance, immediately rush to the hospital.

Causes

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

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 is also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones.

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.

Diagnosis

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 is clear that you are not having a heart attack, your doctor will check to see if your signs and symptoms were caused by broken heart syndrome.

Treatment

There is no standard treatment for broken heart syndrome. Treatment is similar to that of a heart attack until the diagnosis is clear.

Many patients make a full recovery within a month or so. Ask your doctor how long you will need to continue taking these medications once you recover, as most can be stopped within three to six months.

Prevention

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

Many doctors recommend long-term treatment with some medications that block the potentially damaging effects of stress hormones on the heart. Recognising 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.

The writer is an Assistant Professor of Medicine at Z H Sikder Women's Medical College and Hospital, Dhaka.