Death by heartbreak: fact or fiction?

Dying of a broken heart – words normally reserved for poets, romantics and the pages of 1930s Mills and Boon novels are now featuring in medical research journals all over the world.

Heart specialists and researchers have been studying a potentially fatal heart condition which happens when the body releases a massive dose of adrenaline. This stuns the heart, weakens the muscles and results in heart failure.

Takotsubo cardiomyopathy, first described medically in 1991 by Japanese doctors, is also known as broken heart syndrome. It is a condition triggered by intense rushes of emotion and most cases are associated with instances of bereavement, panic, overwhelming fear or even excessive feelings of happiness.

Physical traumas, including arduous childbirth or subjection to forcible restraint, are other situations where broken heart syndrome –  or stress cardiomyopathy – can occur due to the increase in an individual’s stress levels.

Around 1-2% of people, usually older women, who are initially suspected of having a heart attack, are found to have suffered from broken heart syndrome. Although little is known about the condition, the typical symptoms are similar to a regular heart attack: chest pains, shortness of breath, nausea, vomiting and palpitations. Often the similarities in symptoms of both conditions can lead to misdiagnosis, which has resulted in unreliable medical statistics.

Speaking to The College View, Dr Angie Brown, Medical Director of the Irish Heart Foundation said: “Takotsubo cardiomyopathy is caused by a sudden temporary weakening of a muscle in the heart called the myocardium. Because this weakening can be triggered by emotional stress, such as the death of a loved one, a break-up, or constant anxiety, the condition is often known as broken heart syndrome.

“The typical presentation in someone sees a sudden onset of chest pain and/or heart failure. It appears to be more commonly seen in post-menopausal women. Often there is a history of a recent severe emotional or physical stress. Despite the grave initial presentation in some patients, most patients survive the initial acute event, with a very low rate of in-hospital mortality or complications.”

Dr Alexander Lyon, a lecturer at London’s Imperial College and a consultant cardiologist at specialist heart and lung hospital, the Royal Brompton Hospital, said: “To a cardiologist, a heart attack means a blocked coronary artery, but in this condition we find the coronary arteries are open and the blood supply is fine. We then look at the pumping chamber and it’s paralysed, plus it’s taken on a unique and abnormal shape. It looks like a Japanese fisherman’s octopus pot, called Takotsubo, hence its name.

“Currently it is not fully known how to treat these patients. Insights show that the illness may be protecting them from more serious harm. We’ve identified a drug treatment that might be helpful, but the most important thing is to recognise the condition, and not to make it worse by giving patients with Takotsubo cardiomyopathy more adrenaline or adrenaline-like medications.”

One very famous case of alleged broken heart syndrome is American singer Johnny Cash. He died less than four months after his wife June, but complications from diabetes was the official cause of death recorded.

Jennifer Holmes

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