Chest pain and shortness of breath should always be taken seriously. These symptoms can signal a heart attack, but they can also be signs of something less sinister—a broken heart. We usually use the term “broken heart” to describe one’s state of mind after a romantic breakup, but there is a medically-recognized condition by the same name.

Broken heart syndrome, also known as stress cardiomyopathy, is a temporary disorder that can feel like a heart attack, but there is no blockage of the coronary arteries. Blood flow to smaller arteries may be reduced, disrupting the heart’s pumping action while the rest of the system continues to function properly. The heart may even contract more forcefully, but inefficiently. The left ventricle enlarges when this happens, which can lead to structural changes in the heart muscle if left untreated. Fortunately, broken heart syndrome usually reverses itself in a few days or weeks. Most people recover quickly and don’t suffer long-lasting effects.

Broken heart syndrome is often brought on by stressful situations and extreme emotions, like those following bereavement or a heated argument. The condition can also be triggered by a physical illness or surgery, such as an asthma attack or broken bone. 

While the exact cause of broken heart syndrome is unclear, two molecules associated with stress, depression, and anxiety have been identified in patients, and these molecules seem to be more sensitive to adrenaline.1 Adrenaline is one of the main stress hormones your body produces, and it is released in great quantities during the physical and emotional episodes that precede a cardiac event. Drugs that speed up the heart, including nasal decongestants, corticosteroids, methamphetamine, and cocaine cause the syndrome in rare cases.

The syndrome was first differentiated from heart attack in Japan in 1990, and since then, it has been on the rise. An analysis of cases from 2006 – 2017 showed that broken heart syndrome is most likely to occur in women ages 50 to 74.2 It makes its appearance in the perimenopausal period when estrogen, a hormone that is protective against heart disease, declines precipitously. It also occurs more frequently in people who have a previous or current mental health disorder.

COVID-19 has increased anxiety levels worldwide, so it’s no surprise to see stress cardiomyopathy spike recently. One study of broken heart syndrome in people with existing coronary disease found that just like with COVID itself, outcomes vary depending on a patient’s comorbidities—diseases that exist alongside the primary condition.3

If you’re having chest pain, a rapid or irregular heartbeat, or shortness of breath after a stressful event, call 911 immediately. Emergency medical professionals will be able to determine if you have broken heart syndrome by performing an EKG, blood tests, and an echocardiogram, all of which are fast and easy to complete. With timely supportive care, the risk of recurrence is just three percent.4

Dr. Jessica Needle is a licensed naturopathic doctor with Optimal Health Center in Palm Desert and can be reached at (760) 568.2598. 

References: 1) https://www.theguardian.com/science/2021/jun/21/high-stress-may-make-broken-heart-syndrome-more-likely-takotsubo-cardiomyopathy; 2) https://doi.org/10.1161/JAHA.120.019583; 3) https://jamanetwork.com/journals/jamanetworkopen/fullarticle/276809; 4) https://www.internationaljournalofcardiology.com/article/S0167-5273(18)32811-0/fulltext

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