Broken Heart Syndrome by Bhavleen Kaur Sethi

~Bhavleen Kaur Sethi

Broken Heart Syndrome, also known as Stress cardiomyopathy or takotsubo cardiomyopathy, is a serious ailment. It is a condition of the heart that is frequently triggered by abrupt physical or emotional stressor. The syndrome can also be brought on by a severe physical ailment or surgery. Unlike a heart attack, broken heart syndrome occurs when your heart muscle weakens suddenly due to a physical or mental stressor. Treatment options include cardiac rehabilitation, anti-anxiety medicines, stress reduction, and stress management. In the majority of cases, this is a temporary, reversible heart issue. But even after the hearts have healed, some people could still feel sick.

The most common reason for heart attacks is a cardiac artery that is completely or nearly completely blocked. Heart arteries are not blocked in broken heart syndrome. The heart's arteries, however, might have decreased blood flow.

Broken heart syndrome has a variety of names and forms, including: 

• Takotsubo cardiomyopathy 

• Apical ballooning Syndrome (or transient apical ballooning syndrome). 

• Gebrochenes-Herz Syndrome 

• Stress Cardiomyopathy (or stress-induced cardiomyopathy).

Broken Heart Syndrome Triggers:

Broken heart syndrome can be caused on by both positive and negative stressful emotional occurrences, such as:

• The loss of a close relative 

• Surgery 

• Serious illness 

• Money issues 

• Abuse 

• Speaking in public 

• Losing job 

• Having a divorce 

• Car crashes 

• Traumatic memories 

• Obtaining a lottery win 

• Being the special guest at a surprise celebration

  
  
  

Sometimes, certain medicines may result in broken heart syndrome because they may cause your body's hormone levels to spike. These medicines include: 

• Treatment for severe allergic responses is epinephrine. 

• Venlafaxine (Effexor XR), an antidepressant, and duloxetine (Cymbalta), which helps cure nerve issues in diabetics and is also an antidepressant, and levothyroxine (Synthroid, Levoxyl), which can address thyroid issues 

• Methamphetamine 

• Cocaine

Types:

• Apical: More than 80% of instances fall under this category, making it the most prevalent. The lower half of heart is impacted. 

• Mid-ventricular: This type affects your ventricles' middle region. The area that is affected resembles a belt or ring around your heart. The upper and lower regions of heart continue to work normally. 

• Basal: The damaged region resembles a ring or belt and is higher up than the mid-ventricular region. The only part of the body that operates regularly is below the belt. About 2% of cases are of this extremely rare variety.

• Focal: This is the least common form, accounting for only around 1% of occurrences, and it affects a significantly smaller geographic area than the other varieties. The afflicted region develops a bulge that is clearly visible in comparison to the rest of your heart. The opposite side of heart curves inward toward the bulge.

Risk Factors:

The following are risk factors for broken heart syndrome: 

• Sex: Women are more likely than men to experience broken heart syndrome. 

• Age: The majority of those who suffer from broken heart syndrome are above 50. 

• Chronic Stress: People who experience chronic stress may be more prone to broken heart syndrome.

• Mental health ailments: Broken heart syndrome may be more common among people with anxiety or depression.

Causes:

Broken heart syndrome has an uncertain causes, according to researchers. They do, however, think that stressful situations like a divorce, automobile accident, or job loss can contribute to it. Adrenaline, noradrenaline, epinephrine, and norepinephrine are among the stress hormones that are released into the blood when you respond to physical or emotional stress. According to experts, these hormones momentarily block your heart's ability to beat. 

Broken heart syndrome, also known as takotsubo cardiomyopathy, affects a small percentage of persons who are unable to pinpoint any specific stresses that may have triggered their episode.

Broken Heart Syndrome: 

• disrupts the regular, steady rhythm of your heart (pattern of heartbeats). 

• causes a temporary enlargement of a portion of your heart (the lower part of your left ventricle). 

• leads to other regions of your heart contracting even more forcefully. 

These alterations result in momentary heart muscle failure.

Examples of Unexpected Emotional pressures include:

• Grief resulting from a loved one's passing or another significant loss (relationship, home, money or a beloved pet). 

• Good news (surprise parties, winning the lottery). 

• Devastating news 

• Extreme fear (public speaking, armed robbery). 

• Extreme anger

Example of Sudden Physical stressors include:

• Extreme pain 

• An intense physical activity. 

• Health problems, such as asthma attacks, dyspnea (difficulty breathing), seizure, stroke, high temperature, hypoglycemia (low blood sugar), significant blood loss, or surgery.

Signs and Symptoms: 

• One of the key symptoms is sudden, acute chest pain (angina). 

• Breathlessness is a primary symptom. 

• The left ventricle of heart become weaker is the main symptom. 

• Abnormal heartbeats (arrhythmias). 

• Low blood pressure (hypotension). 

• Palpitations in the heart 

• Fainting (syncope) (syncope).

After the traumatic event, you could experience broken heart syndrome symptoms immediately or hours afterwards. Stress hormones temporarily paralyse your heart muscle, causing symptoms resembling a typical heart attack.

Complications: 

Complications are relatively rare, however they could include: 

• Pulmonary edema.

• Rupture of the left ventricle of heart.

• A blockage in the left ventricle's blood flow. 

• A heart attack. 

• Blood clot in the wall of left ventricle of heart.

• Cardiogenic shock 

• Cardiac block 

• Death.

Treatment:

Takotsubo cardiomyopathy, often known as broken heart syndrome, has no recognised treatment, however the majority of patients fully recover after starting medication. The majority of patients with broken heart syndrome begin to feel better as they continue their treatment. That may take place while you are having treatment in the hospital or only hours or days later. Medications consist of: 

• Aspirin to promote blood flow and avoid blood clots. 

• To reduce blood pressure and combat inflammation, use ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers). 

• The use of beta-blockers to lower heart rate. 

• Diuretics to reduce fluid retention

Side Effects of Treatment:

In general, the following are some treatment-related side effects that could occur: 

• Medications: You may experience adverse drug interactions or allergic responses to the medications you use. 

• Mechanical assistance tools: bleeding, blood clots, infections, heart attacks, strokes, and bleeding.

Prevention:

The broken heart syndrome has no recognised therapies. However, acquiring problem-solving and stress management skills can assist you in reducing your level of mental and emotional stress. 

Many medical professionals advise long-term treatment with beta blockers or related medications to stop further instances of broken heart syndrome. These drugs inhibit the heart's vulnerability to the negative effects of stress chemicals. 

Broken heart syndrome risk may be increased by persistent stress. The heart's health can be improved by managing emotional stress, which may also help prevent broken heart syndrome.

Techniques for relaxation are also beneficial for managing and reducing stress.

Several instances include: 

• Exercising awareness, journaling, yoga, or meditation. 

• Having a hot bath. 

• Lighting fragrant candles 

• Letting out breaths gently and deeply.

One might be able to join a support group to talk about your stress and exchange coping mechanisms, depending on the cause of your stress. A qualified counsellor can also be of assistance. 

Additionally, establishing healthy habits might aid in managing mental or physical stress. Among these behaviours are: 

• Eating a nutritious diet, such as the Mediterranean or Dash diet. 

• Regularly exercising (at least five times a week for 30 minutes). 

• Sleeping for seven to nine hours every night. 

• Interacting with others. 

• Maintaining your doctor's appointments for examinations and screenings. 

• Avoiding the use of cigarette products, illegal drugs, and excessive alcohol. (Your healthcare physician can point you in the direction of useful resources if you currently use these substances and wish to stop).

Prognosis: 

Broken heart syndrome is a transient ailment for the majority of people. The heart muscle is not permanently damaged, therefore you should recover without any long-term heart issues. After a stressful experience, most people recover fully between a few days to a few weeks. 

         Consult your healthcare practitioner for advice on how to manage any lingering medical conditions that may have contributed to your broken heart syndrome episode, such as asthma, seizures, or a stroke. 

       A follow-up echocardiography may occasionally be recommended by your doctor four to six weeks after your incident. They'll check to see whether you have any heart conditions and if your left ventricle is functioning correctly once more.

Dos:

• Do look after yourself. 

• Do cherish the pleasant memories. 

• Do reconsider your requirements. 

• When you're ready, give it another shot. 

• Be sure to forgive yourself as well as the other person.

Don’ts

• Don't allow your feelings take control. 

• Avoid thinking about the past. 

• Never ignore your needs. 

• Stay away from rebound relationships.

Broken Heart Syndrome is a term used to describe a situation when the heart function suddenly declines. The disorder is known medically as apical ballooning syndrome, stress cardiomyopathy, or takotsubo cardiomyopathy. Women aged 58 to 75 account for more than 90% of reported cases. According to research, this disease affects up to 5% of women who are thought to be experiencing a heart attack. Typically, there is no permanent heart damage after recovery. Shortness of breath and chest discomfort are the prominent symptoms.

         Medication used to treat heart failure is frequently used as treatment for broken heart syndrome. Using drugs like ACE inhibitors or beta-blockers, the intention is to enhance how your heart contracts and pumps blood. 

         People who suffer from broken heart syndrome typically heal in a matter of weeks. 

There is no way to entirely avoid stress in your life, and being under stress doesn't always result in broken heart syndrome. 

          The secret is to be aware of your body. Visit your healthcare practitioner if you think there might be a problem. One of your body's most vital organs, your heart helps to keep you healthy in a variety of ways. However, it can require a little more care and attention during times of extreme stress.