diagnosis: broken heart

A broken heart is not just the stu of love poems or romantic novels and movies. Turns out that broken-heart syndrome is a recognized medical condition that a ects women more than men. And it can be deadly. When actress Debbie Reynolds died one day after her daughter, Carrie Fisher, many said that she died from a broken heart.

O cially known as stress-induced cardiomyopathy or takotsubo cardiomyopathy, Japanese researchers were the first to describe the syndrome in 1990. They named it takotsubo, which means “octopus pot or trap” and which resembles the malfunctioning heart in imaging studies.

“Broken-heart syndrome is a response to any kind of acute emotional stress, such as the death of a loved one, a divorce or loss of a job. It can even happen because of something good like a wedding or birth of a child,” says Dr. Srisha Rao, a cardiologist with Ocala-based Cardivascular Institute of Central Florida. “Too much of the stress hormone cortisol floods the system and stuns the heart muscle.”

Rao adds that “patients have all the markers of a heart attack, such as chest pain and shortness of breath.” A part of the heart temporarily enlarges, while the rest of the heart functions normally or with more forceful contractions. Irregular heartbeats (arrhythmias) or cardiogenic shock may also occur. In cardiogenic shock, a suddenly weakened heart can’t pump enough blood to meet the body’s needs, and it can be fatal.

“Women may su er more than men from broken-heart syndrome because women’s blood vessels are more reactive than men’s,” says Rao. “I definitely encounter it in my practice, especially in postmenopausal women. That could be tied into a heightened stress response due to lack of estrogen.”

In broken-heart syndrome, test results di er from those of heart attack patients, including: blood tests show no signs of heart damage, heart catheterization shows no blockages in the coronary arteries, EKG results look di erent and atypical ballooning and unusual movement of the left lower heart ventricle. Although there is no standard treatment for broken-heart syndrome, most people stay in the hospital while they recover.

WOMEN may suffer more than men from broken-heart syndrome because women’s blood vessels are more reactive than men’s.

“Once we establish that it is brokenheart syndrome, to err on the side of caution, I do treat it like I would a regular heart patient,” says Rao, “and prescribe medication.”

Those medications usually include angiotensin-converting enzyme (ACE) inhibitors, beta blockers or diuretics. Most meds can be stopped within three to six months. Follow-up care will likely include an echocardiogram about a month after diagnosis and regular checkups as necessary. Sources: heart.org, mayoclinic.org, webmd.com