Dr. Fred M. Krainin, McLeod Interventional Cardiologist
I
contributing writer
Broken Heart Syndrome Broken heart syndrome, which is also known as apical ballooning syndrome or
stress-induced cardiomyopathy, was first described by Japanese doctors in 1991. These physicians named this condition takotsubocardiomyopathy. In Japanese, “tako-tsubo” means “octopus pot,” which is the device used by Japanese fisher- men to catch octopus. The leſt ventricle of a patient diagnosed with this condition resembles that shape. It is a condition thought to be caused by intense emotional stress, result- ing in rapid and severe heart muscle weakness and a temporary enlargement in part of the heart (cardiomyopathy). Some examples of triggers for broken heart syndrome can include the death of a loved one, extreme anger or surprise. Emotional stressors are not the only triggers for this disorder. Physical stressors such as surgery, seizure and car accidents can also prompt cardiomyopathy. The stress response, caused by perceived threats, is the so called “fight or flight”
response. This in turn leads to high blood pressure, increased heart rate, sweat- ing and a feeling of anxiety, as well as increased alertness. It is believed that in susceptible individuals, the heart can become overwhelmed by the surge of a drenaline produced in response to the stressors. This is suspected of contributing to the abnormal findings in broken heart syndrome. The exact cause of broken heart syndrome is undetermined. Symptoms are identical to those that heart
attack victims experience. These include chest pain, shortness of breath, nausea and sweating. The symptoms typically appear within minutes or hours aſter the person has been exposed to the physical or emotional stress. Although the symptoms are very similar to those of a heart attack, there are some important and distinct differences. One of the main differences between heart attack and broken heart syndrome is that broken heart syndrome is usually completely reversible. Most people who experience broken heart syndrome have normal coronary arteries without the severe blockages or clots seen in the arteries of heart attack victims. In general, the long term prognosis for patients who have experienced broken
heart syndrome appears to be excellent because the heart muscle is not permanently damaged. It is rare for an individual to experience a recurrence once they have
recovered.This condition is seen almost exclusively in post-menopausal women, although the reason for this is unclear. Originally felt to be rare, more and more cases are appearing and it seems to be more common than once thought. It is not unusual for us to see one or more cases a month here in the Pee Dee. Because this is a newly recognized condition, ongoing research is being done
to gain more understanding about this syndrome. If you or a loved one experi- ences chest pain, shortness of breath, or other symptoms of heart attack, call 911 and go immediately to your nearest emergency room. The Chest Pain Center at
Dr. Kranin is an interventional cardiologist who performs many diagnostic and interventional procedures in the McLeod Cardiac Catheterization laboratory. He is in practice with Pee Dee Cardiology.
the McLeod Emergency Department is staffed 24 hours a day, seven days a week by experienced healthcare professionals trained in recognizing and treating a heart attack. Once you arrive at the hospital, an electrocardiogram (EKG) will be performed
to evaluate any heart abnormalities and an echocardiogram (ultrasound of the heart) may also be performed to take a closer look at the left ventricle. However, the diagnosis can only be definitively made with a heart catheterization, which will show the typical findings of the octopus pot shaped heart with normal coro- nary arteries. The standard treatment for broken heart syndrome is the same as for a traditional heart attack. Some patients can become critically ill, just like a se- vere heart attack; occasionally, it can even result in death. However, most people recover and leave the hospital in several days to a week.
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February 2014
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