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Spotlight: What Really Happens During “Broken Heart Syndrome?

separator It can mimic a heart attack, but it’s really something completely different. It’s called “stress cardiomyopathy,” or “broken heart syndrome.” 

We’ve all heard of people having heart attacks after getting bad news. But sometimes, bad news, or even something as seemingly happy as a surprise party, can trigger a different kind of attack. 

What happens during broken heart syndrome?
For some people, sudden, overwhelming emotional stress causes the release of the hormones called “catecholamines,” most notably adrenaline and noradrenaline, into the bloodstream. This can “stun” the heart muscle, diminishing its ability to pump blood, and cause the typical symptoms of a heart attack, including chest pain, fluid in the lungs and difficulty catching your breath. 

Heart attacks occur when a blockage, usually a clot in the arteries, interrupts blood supply to the heart. When people experience broken heart syndrome, however, testing usually reveals no such blockage. Additionally, during a heart attack, the heart muscle can become damaged, and when this happens, enzymes are released into the bloodstream. People with broken heart syndrome do not have these enzymes in their blood. And MRIs reveal that they have not suffered any permanent muscle damage as a result of their attack. 

Additionally, researchers found that people with broken heart syndrome had catecholamine hormone levels that were two to three times higher than the heart attack patients, and seven to 34 times higher than normal levels, another clear sign that the problem was caused by stress. 

Recovery quicker than after heart attack
Patients suffering from at attack of broken heart syndrome generally see an improvement in their heart’s pumping ability within a few days. They’re usually completely recovered within two weeks. On the other hand, people often need weeks or months to recover from a heart attack, and muscle damage is often permanent. 

What can cause broken heart syndrome?
In a recent study on broken heart syndrome, patients experienced symptoms after such events as the death of a loved one, being the guest of honor at a surprise party, having to speak in public, being the victim of an armed robbery, appearing in court or being in a car accident. Most people who suffer from the syndrome are women. 

Researchers don’t yet know how catecholamine hormones act to stun the heart. They also don’t know why more women are affected than men, nor do they know whether there is a genetic component to the syndrome. But one thing is clear: if you have heart attack symptoms and you have had a severe emotional shock, be sure to tell your doctor about it. It’s important for the people who treat you to know whether you’re actually having a heart attack or whether you’re suffering from stress cardiomyopathy.

New England Journal of Medicine online, 9 February 2005; Johns Hopkins Medicine Press Release, 9 February 2005.
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