CAN A BRO­KEN HEART RE­ALLY HARM YOUR HEART? AD­VICE FOR THE CON­DI­TION THAT MIM­ICS HEART AT­TACKS

A CON­DI­TION DUBBED BRO­KEN HEART SYN­DROME MIM­ICS HEART AT­TACKS AND AF­FECTS MOSTLY WOMEN, BUT WHY? PATSY WESTCOTT RE­PORTS

Woman & Home - - Contents -

MOST OF US KNOW THAT SURGE OF ADREN­A­LINE THAT COMES FROM A SUD­DEN SHOCK, RE­CEIV­ING TER­RI­BLE NEWS OR EVEN

DI­VORCE OR BE­REAVE­MENT,

BUT COULD SUCH EMO­TIONAL TRIG­GERS

LEAD TO A SE­RI­OUS CHANGE IN THE WAY

OUR HEART FUNC­TIONS?

THE RIS­ING DI­AG­NO­SIS OF BRO­KEN

HEART SYN­DROME, SO-CALLED BE­CAUSE IT IS OF­TEN TRIG­GERED BY SE­VERE EMO­TIONAL OR PHYS­I­CAL STRESS, SUG­GESTS THEY COULD. IN THE UK ABOUT 3,000 PEO­PLE EX­PE­RI­ENCE BRO­KEN HEART SYN­DROME – MED­I­CALLY CALLED TAKOTSUBO CARDIOMYOPATHY – EACH YEAR. AND THIS FIG­URE IS RIS­ING. NINE OUT OF TEN OF THOSE AF­FECTED ARE WOMEN.

FIRST IDEN­TI­FIED BY A JA­PANESE

DOC­TOR IN 1990, THE CON­DI­TION IS OF­TEN MISDIAGNOSED AS A HEART AT­TACK,

AS THE SYMP­TOMS ARE VERY SIM­I­LAR. “THE HEART EVEN RE­LEASES THE SAME MARKER CHEM­I­CALS PRO­DUCED AF­TER AN AT­TACK, AL­BEIT IN SMALLER QUAN­TI­TIES,” EX­PLAINS CON­SUL­TANT CARDIOLOGIST, DR DANA DAW­SON, OF AB­ERDEEN UNI­VER­SITY.

IN TAKOTSUBO, HOW­EVER, THE BLOCKED ARTERIES THAT PRE­VENT THE FLOW OF OXY­GEN-RICH BLOOD TO THE HEART AS IN A TRUE HEART AT­TACK ARE MISS­ING, AND

THE HEART’S MAIN PUMP­ING CHAM­BER, THE LEFT VENTRICLE, BALLOONS. IT’S THIS FEA­TURE THAT LED TO THE NAME TAKOTSUBO, AF­TER A ROUND-BELLIED POT JA­PANESE FISH­ER­MEN USE TO TRAP OC­TO­PUS. “IN THE PAST, TAKOTSUBO WAS VERY OF­TEN MISSED OR MISDIAGNOSED,” EX­PLAINS DR DAW­SON. “WE NOW BE­LIEVE IT COULD BE THE TRUE CUL­PRIT IN AS MANY AS SEVEN OUT OF 100 PRESUMED HEART AT­TACKS.”

THE GOOD NEWS IS THAT CARDIOLOGISTS ARE NOW MORE AWARE OF THE CON­DI­TION.

What causes takotsubo?

ONE THE­ORY IS THAT

IT’S AN ABNORMAL RE­AC­TION OF THE HEART

TO A SUD­DEN SURGE OF THE STRESS HOR­MONE, ADREN­A­LINE. THIS SETS OFF A CHEM­I­CAL CHAIN RE­AC­TION, WHICH ENDS IN THE HEART BE­COM­ING IN­FLAMED AND DE­PLETED OF THE EN­ERGY NEEDED TO FUEL THE CON­TRAC­TION OF ITS CELLS. THE BALLOONING HAP­PENS BE­CAUSE ONE PART OF THE HEART CON­TRACTS POORLY REL­A­TIVE TO THE REST. BLOOD IN THE PARTS CON­TRACT­ING NOR­MALLY IS PUSHED OUT OF THE HEART, WHILE BLOOD IN­SIDE THE POORLY CON­TRACT­ING PART BE­COMES TRAPPED.

Why are women most af­fected?

IT’S NOT CUR­RENTLY KNOWN, BUT THE RISK IN­CREASES WITH AGE. IT’S BEEN RE­PORTED

THAT OLDER WOMEN’S HEARTS HAVE CER­TAIN SPE­CIALISED CELLS ON THEIR SUR­FACE, WHICH TEND TO RE­SPOND ABNORMALLY TO ADREN­A­LINE, SO THIS COULD BE A FAC­TOR. BUT ANY­ONE OF ANY AGE CAN BE AF­FECTED, IN­CLUD­ING MEN.

How is it treated?

BE­CAUSE OF THE RISK OF SHOCK OR LIFETHREAT­EN­ING ELEC­TRI­CAL IN­STA­BIL­ITY OF THE HEART DUR­ING THE EARLY STAGES OF AT­TACKS, SUF­FER­ERS ARE AD­MIT­TED TO A SPE­CIAL­IST CORONARY CARE UNIT FOR AT LEAST TWO DAYS. “THERE IS NO CON­SEN­SUS ON LONGER-TERM MEA­SURES. THERE HAVEN’T BEEN ANY

TRIG­GER POINTS

IN MORE THAN 85% OF SUF­FER­ERS, TAKOTSUBO FOL­LOWS A PHYS­I­CALLY OR EMO­TION­ALLY STRESS­FUL EVENT IN­CLUD­ING:

SE­RI­OUS ILL­NESS RE­CEIV­ING BAD NEWS A CAR AC­CI­DENT GRIEF – CLASSICALLY DUE TO A BE­REAVE­MENT, A BREAK-UP OR DI­VORCE MA­JOR CRISES SUCH AS WAR A CON­FLICT OR AR­GU­MENT

CLIN­I­CAL TRI­ALS YET TO EX­PLORE MEDICINES THAT MAY HELP THE HEART RE­COVER BET­TER OR PRE­VENT RE­CUR­RENCE, ALTHOUGH WE’RE LEARN­ING ALL THE TIME,” SAYS DR DAW­SON.

Any last­ing ef­fects?

IT WAS THOUGHT THE HEART RE­COV­ERED FULLY WITHIN THREE MONTHS. BUT NEW RE­SEARCH AT THE UNI­VER­SITY OF AB­ERDEEN, FUNDED BY THE BRI­TISH HEART FOUN­DA­TION AND LED BY DR DAW­SON, RE­VEALS FULL RE­COV­ERY MAY TAKE LONGER. THE SQUEEZING AND WRING­ING MOVE­MENTS ARE STILL IM­PAIRED FOUR MONTHS AF­TER AN AT­TACK AND SCARRING CAN OC­CUR, RE­DUC­ING ELASTICITY AND PRE­VENT­ING THE HEART FROM CON­TRACT­ING PROP­ERLY.

THIS PARTLY EX­PLAINS FIG­URES SHOW­ING A SMALL RISK OF DEATH EVEN YEARS LATER.

Know the symp­toms

SEEK IM­ME­DI­ATE MED­I­CAL HELP IF YOU EX­PE­RI­ENCE CHEST PAIN AND SHORTNESS OF BREATH FOR ANY­THING FROM A FEW MIN­UTES TO HOURS, DAYS OR WEEKS AF­TER SE­VERE EMO­TIONAL OR PHYS­I­CAL STRESS.

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