19 Mar 2015 Broken Heart Syndrome with Dr. Katherine Durham

by Hazel Halliburton

Whether it be routine stress of everyday life, stress brought on by sudden negative change or the traumatic stress of losing a loved one, women experience stress on a daily basis.

While researchers are unsure if there is any direct effect from stress on cardiovascular health, stress can often result in poor health choices that could ultimately harm one’s heart health.

With stress oftentimes people experience high blood pressure, not getting enough quality sleep, less time to take for one’s self to relax and recharge or exercise and in most cases, poor eating choices. Some people resort to substance use such as tobacco or alcohol to relieve stress. Over time, all of these side effects and activities can wear on the heart.

In some cases of severe stress, women can experience Stress-Induced Cardiomyopathy or what is also known as Takotsubo Cardiomyopathy or Broken Heart Syndrome.

The word “takotsubo” comes from a Japanese word that means “octopus trap.” In the case of takotsubo, the bottom part of the heart chamber temporarily enlarges and does not pump well, while the rest of the heart functions normally or even has more forceful contractions, causing a section of the heart to close and resemble an octopus trap, according to the American Heart Association.

“Takosubo is a stress-induced sickness of the heart muscle,” said Dr. Katherine Durham, cardiologist at Unity Health Cardiology Clinic. “For all practical purposes, it can clinically look just like a woman is having a heart attack. The symptoms can include sudden onset pain from the chest throughout the arm and the jaw. You can experience shortness of breath and break out in a sweat.”

After a patient is admitted to the emergency room, an EKG is done. Often, it will appear to be a heart attack and there can be EKG changes that will look like a heart attack as well. The next step is to take the patient to the Cath-lab where an angiogram is then performed where the physician injects dye into the heart’s arteries to examine if there is a blockage. In the case of takotsubo, the arteries will look fine and no blockages will be found. Dye is then injected into the pumping chamber of the heart, which is called an LV gram. This is the only way to determine a takotsubo diagnosis. When the dye is injected into the pumping chamber of the heart, doctors can easily see the outline of what appears to be an octopus trapping pot; takotsubo.

Patients with takotsubo can be critically ill and require ICU care, fluid removal and might suffer from cardiogenic shock. They may need medication to help support their blood pressure or for congestive heart failure. The majority of cases can be resolved within a month if proper care and medication is given.

Johns Hopkins Medicine defines “stress” as being the body’s response to things it perceives as abnormal. In the occurrence that the body goes through sudden, major stress, it produces various hormones which are meant to help cope with stress. In all cases of takotsubo, the root of the cause can always be traced back to a sudden stress-related event.

Stress fills everyday life and cannot be completely avoided, thus there are no real measures for preventing takotsubo. While this may be true, it is beneficial to know that 95 percent of patients who experience it completely recover within four to eight weeks. As of now, no studies show that there is any link between takotsubo and genetics and there is only a 3 percent chance of it ever coming back.

Although not all stress can be prevented, making healthy lifestyle changes can help decrease stress levels. Making sure to incorporate exercise into your daily activities, getting an adequate amount of sleep and finding something you enjoy doing can also help relieve stress.

If your physician has advised that you visit a cardiologist or if you have questions and would like to receive more information about the services at Unity Health Cardiology Clinic, please call 501.279.9393.

Broken heart syndrome

Signs and symptoms

The most common signs and symptoms of broken heart syndrome are angina (chest pain) and shortness of breath.

Arrhythmias (irregular heartbeats) or cardiogenic shock also may occur. Cardiogenic shock is a condition in which a suddenly weakened heart can’t pump enough blood to meet the body’s needs, and it can be fatal if it isn’t treated right away.

Difference between a heart attack and broken heart syndrome

Some signs and symptoms of broken heart syndrome differ from those of heart attack. In broken heart syndrome, symptoms occur suddenly after extreme emotional or physical stress.

Other differences:

EKG (a test that records the heart’s electric activity) results don’t look the same as the EKG results for a person having a heart attack.
Blood tests show no signs of heart damage.
Tests show no signs of blockages in the coronary arteries.
Tests show ballooning and unusual movement of the lower left heart chamber (left ventricle).
Recovery time is quick, usually within days or weeks (compared with the recovery time of a month or more for a heart attack).
Source: American Heart Association/heart.org

Unity Health Cardiology Clinic:

Unity Health Cardiology Clinic is a hometown cardiology clinic. With doctors who have been serving the White County and surrounding areas for more than 33 years, Unity Health Cardiology Clinic believes it is important to serve the community by providing it with the best quality care possible and latest and most advanced technologies and services available.

Located at 711 Santa Fe Dr., Unity Health Cardiology Clinic hours are 8:30 a.m. to 5 p.m. Monday through Friday. For more information about services, please call 501.279.9393.