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Broken heart syndrome becoming more common

Reviewed by Stephen Willis, MD

Do you believe that you can die of a broken heart? Well it appears that the heart can become broken without it being considered a ‘traditional’ heart attack. The heart can become tired and weak and just break; this is according to various cardiologists. They have seen and treated the condition and they say it can be caused by the death of a loved one or a relationship breakup, in fact all the things we relate a broken heart to.

In one example, the patient, a lady was just helping at a church event when she became unwell, complaining about pains in her chest. She tried to lie down and rest in a relative’s car but the pressure on the chest increased. When she didn’t recover her daughter called for an ambulance. The doctor’s original diagnosis was a heart attack, however after the EKG, angiogram and other tests it was found that her heart was ok and all blood levels affecting the heart were ok too. It was now that the doctor changed the diagnosis to stress cardiomyopathy, this is the name of the condition which copies all of the heart attack symptoms so well.

David Nagelhout is a cardiologist at North Central Heart Institute in Sioux Falls, S.D. and he says, "It typically occurs in middle-aged or older women. They present with classic symptoms of chest pain, shortness of breath and EKG changes that look like a classic heart attack, but on angiogram, their arteries are normal".

Nagelhout explains that more doctors are seeing stress cardiomyopathy and it is now being recognized as a heart syndrome. He expands that we are seeing many more cases and it is common to happen to someone who has had been subjected to emotional stress, which can be brought on by financial problems, family death or serious illness or living in an unhappy and perhaps abusive relationship.

In the case of the patient discussed earlier, her close friend had recently died and she was struggling to break away from an abusive husband.

Nagelhout remembers his first case 20 years ago. He admits that he didn’t know what it was. The woman showed all of the typical heart attack symptoms yet all of the tests indicated that the arteries were normal. He then found out the woman had recently suffered a very stressful situation. Her son had just been handcuffed and arrested as she stood by and this was the ‘fallout’. Nagelhout says that he has seen the condition a dozen or so times since then.

Addie Graham-Kramer, regional vice president of the American Heart Association explains that we now know that if there are no excruciating or back pains then the likelihood of the condition being a heart attack reduces. These symptoms are amongst the most common in heart attacks.

However many people do not even know that they are stressed. It is only when they analyze their life after having an episode do they realize that things have happened which cause stress.

It’s when the angiogram is found to be good, and cholesterol normal and all of the other heart examinations do not show any negative indications that the patient understands the power of stress.

Our patient spent four days in hospital and in that time understood the importance of changing her lifestyle. After leaving hospital she committed to regular exercise and now says that she is more understanding of the demands put upon her body.

She has also changed her eating and drinking habits as part of her lifestyle change, now she eats more fish, fruit and vegetables and avoids processed food. And she monitors her salt intake as a matter of routine. In addition to this she now listens to her body and believes that if you experience something in your body then you should take action. It’s your body, you are the expert.

Although it has been around for years now, Nagelhout admits that broken heart syndrome is not very well understood. He adds, "It appears to be an overwhelming surge of stress hormones that causes this to happen with the heart muscle". And patients can suffer all of the other issues associated with heart attack, these can be as severe as the heart stopping or arrhythmia, but in a normal case the patient would expect the heart to recover in less than a month.