Dr Yousuf Ali al Mulla -
We use to hear people saying, my heart has been breaking since that very first day we met, or as far as I remember children’s books show the heart shape broken into two pieces, usually with a zigzag at the cleft.
So, while it’s mysterious, broken heart syndrome is indeed real!
In fact, it arises when a person goes through a setback emotionally like the loss of a loved one, a break-up in a romantic relationship or any such emotional trauma that can result in a lot of impact on the health of the person both mentally and physically. In other words, there are established ties between depression, mental health and heart disease.
Unfortunately, women are more likely than men to experience the sudden, intense chest pain (the reaction to a surge of stress hormones) that can be caused by an emotionally stressful event. It could be the death of a loved one or as I stated above, it could even happen after a good shock.
What I would say here is that such condition is still not fully understood the mechanism of this specific type of acute heart failure syndrome, but it is known that it does not blocked heart arteries and usually make a fast and full recovery. Nevertheless, evidence points to a strong brain-heart interplay.
Different studies have shown that within a few hours of an extreme emotional or physical trauma, stress hormones cause transient (short-lived and not permanent), I would say stunning of the left heart chamber, which is the main heart chamber that pumps blood out to the rest of the body.
The good news about broken heart, usually rapidly reversible. The ventricle or heart chamber typically returns to normal within 14 days, and most patients recover with no long-term heart damage. However, plenty of cases show similar symptoms as if it is heart attack, but clinically the physician through more diagnostic work-up can, fortunately, make such syndrome indistinguishable from those of a heart attack, as the broken heart syndrome is stress-induced cardiomyopathy, meaning that stress has caused dysfunction or failure of the heart muscle.
However, researchers in different study suspected that older women are more vulnerable because of reduced levels of estrogen after menopause and new studies have explained that more than 90 per cent of reported cases are in women ages 50 to 75, which suggests that up to 5 per cent of women evaluated for a heart attack actually have this disorder of the broken heart!
I would say, currently there are no evidence-based guidelines for treating broken heart or what we name it cardiomyopathy, but clinicians usually recommend standard heart failure treatment.
Finally, we must recognize the connection between emotion and cardiac death has long been documented and there have been many reports of seemingly healthy people who have dropped and even died during a natural disaster or traumatic events. I should conclude that it remains a medical mystery!
Dr Yousuf Ali Almulla, MD, Ministry of Health. He is a medical innovator and educator. For any queries regarding the content of the column, he can be contacted at: dryusufalmulla@gmail.com
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