A person’s heart is able to change. When going through a period of unforeseen stress, a person’s heart can alter its shape, resulting in chest pain and other symptoms similar to a heart attack but with the arteries remaining unclogged.
This process is called takotsubo cardiomyopathy or broken heart syndrome due to the prevalence of it occurring at moments of grief after losing a loved one. Women make up the significant majority of patients.
The Journal of the American Heart Association recently published research that showed cases of broken heart syndrome were on the rise, particularly among the “prominent at-risk group”, women between 50 to 74 years old.
Data shows that 135,463 documented cases of the syndrome occurred in the U.S between 2006 and 2017, the trend being found that the yearly occurrence rose consistently in both sexes.
However each diagnosis for a younger woman, or man of any age, was found to correspond to 10 further cases in middle-aged women.
Speaking to Today, Sysan Cheng, the study’s senior author said, “There is something potentially going on around the perimenopausal period such that just beyond 50 and up until age 74, there’s this window of opportunity for the condition to develop in women.”
“Their heart is vulnerable.”
Further study is needed to narrow down the precise reasons but cardiologists have begun to explore theories.
The data is stark, 88% of women make up the cases of Takotsubo Cardiomyopathy in the recent study.
Cheng explained that “There’s something about female biology that puts women more at risk, leading to theories about sex hormones playing a role, but that’s not the whole story because it’s more about the stress hormones.”
Continuing she said that the study indicates that there is a brain-heart connection when examining broken heart syndrome.
When it comes to the factors that can bring on the development of heart disease, smoking, high blood pressure and cholesterol are all widely acknowledged but the question remains, what precisely brings on a cardiac event?
Cheng believes that the study of Takotsubo Cardiomyopathy indicates the trigger could be stress, whether physical, emotional or environmental, that disrupts and alarms the brain-heart access.
Potential stressful situations such as a diagnosis of cancer, divorce, job loss, grief, surgery, severe pain or car accident can trigger the syndrome.
What occurs in broken heart syndrome is that the natural fight-or-flight stress hormones drastically swell disproportionate to the situation.
Cheng says that those with broken heart syndrome are particularly sensitive to this increase in hormones, which results in the impact to the heart muscle and cells.
Previously it has been understood that older persons would be most at risk for Takotsubo Cardiomyopathy but this new data is changing that for researchers.
Now the occurrence of the syndrome is pin-pointed in women 50 to 74, as “particularly rapidly rising.”
Cheng contemplates that perhaps these women have lived long enough to build up life stresses and heart disease risks, high cholesterol for example, however are young enough to generate an intense reaction to stress, a response that dims as people age and reach their 80s.
She says, “We think it’s a combination of being older but not too old, such that the heart is vulnerable and yet the potential for the stress-provoked immune, inflammatory and hormonal activation system to be really revved up — and revved up too much — is still there.”
The American Heart Association notes that Takotsubo Cardiomyopathy tests display ballooning and unexpected movement of the lower left heart chamber yet with no signs of heart damage or impediment in the coronary arteries.
The most common warning signs for broken heart syndrome are chest pain and a shortness of breath however the time to recover is far swifter than after a heart attack.
The scientific naming of the syndrome was inspired by the Japanese word for “octopus pot” due to the particular way the heart changed shape.
Clear imaging, particularly an echocardiogram, of the moving heart has been instrumental in making the diagnosis for many.
Cheng details that the syndrome in the past has been “easy to miss and hard to recognize,” yet with further studies and examination, the medical community is now more aware and able to diagnose when patients explain their symptoms.
Treatments range from eliminating the source of stress, when possible, to assisting cardiac functioning through beta blocks, a type of medication that mitigates stress hormones from influencing the heart.
Further studies have shown that incidents of broken heart syndrome have been rising since the advent of the pandemic.
Authors of the study note that it is not a consequence of the virus itself but instead the stresses brought on by the crisis of the pandemic at large.
Confirming this approach, Cheng weighs in appealing to all, specifically women, to establish all necessary support and stress management techniques to assist with their acute sources of anxiety.
She details “The stress of regular life even outside of the pandemic affects our bodies in so many different ways that we have yet to fully understand,”
“But we know it happens.”
Having a plan to respond and cope with stress may go a long way in safeguarding against broken heart syndrome.
