Study: Stress can cause ‘broken heart syndrome’
AKRON, Ohio – Stress from the coronavirus pandemic is heartbreaking.
A new Cleveland Clinic study led by an Akron General cardiologist discovered the number of cases of “broken heart syndrome,” or stress cardiomyopathy, doubled during the COVID-19 pandemic.
The study, conducted March 1 through April 30, appears in the medical journal JAMA Network Open.
Stress cardiomyopathy occurs in response to physical or emotional distress and causes dysfunction or failure in the heart muscle.
“It’s been associated with severe emotional stress, but it could be any type of stress like breakups, loss of a loved one, a heated altercation with a family member or severe depression,” said Ankur Kalra, an Akron General cardiologist who led the study.
Patients experience the same symptoms as a heart attack, including chest pain and shortness of breath, but usually do not have acutely blocked coronary arteries, Kalra said. In some cases, it can be fatal.
The left ventricle of the heart may show enlargement. Other symptoms include irregular heartbeat, fainting and low blood pressure.
For the study, cardiologists at the Cleveland and downtown Akron campuses looked at 258 patients coming in with heart symptoms known as acute coronary syndrome and compared them with four control groups before the pandemic.
The number of broken heart syndrome cases doubled in March and April from pre-pandemic levels.
Patients during the pandemic had a longer hospital stay compared with those before the pandemic, but there was no significant difference in death. All tested negative for COVID-19.
Typically, 90% of patients with broken heart syndrome are women over the age of 70. In the study, 30% were men, and the median age of all patients was 63.
The condition is usually treated with heart medications and possibly stress medication.
A key to prevention and treatment is reducing stress and practicing self-care, Kalra said.
That is particularly important as the pandemic evolves, said Dr. Grant Reed, director of Cleveland Clinic’s STEMI (ST-elevation myocardial infarction) program and senior author of the study. “Exercise, meditation and connecting with family and friends, while maintaining physical distance and safety measures, can also help relieve anxiety.”
Richard Watkins, 64, knew his life was stressful, but he didn’t expect the stress to nearly kill him.
He has gastroesophageal reflux disease (GERD), a condition in which acid from the stomach comes up into the esophagus, but no previous heart issues.
In the weeks leading up to his health crisis April 15, the pandemic shut down production at General Aluminum Manufacturing in Rootstown, where Watkins is chief financial officer. The auto parts manufacturer laid off 600 employees in several states. Watkins and his wife, Nichol, struggled to help their sons, ages 12 and 10, with online schoolwork.
Watkins’ 2-year-old grandson was in and out of the hospital with Guillain-Barré syndrome, a sudden temporary disorder that took away his ability to walk.
Watkins’ 91-year-old father died after a fall at his home.
“We were getting ready and getting dressed to go to the funeral, and that morning, I came out to breakfast, and I remember parts of it, but I was acting oddly, as my wife would put it,” Watkins said. “I had on a white dress shirt buttoned up to the collar, socks and underwear, but I forgot my pants. She said, ‘What are you doing?’ ”
He said he felt weird. He remembers putting his head down on the table.
His wife called 911 and was instructed by dispatchers to perform CPR. Once crews arrived, they had to shock Watkins’ heart to get a pulse.
Initially, Nichol was told Watkins had a massive heart attack but later was informed that his arteries weren’t blocked.
The diagnosis: broken heart syndrome. Watkins was placed into an induced coma with a ventilator and did not regain consciousness for five days.
Watkins took six weeks off work and has been working on reducing his stress levels.
“I hope people realize, listen to your body. If your body is tingling, if you’re having chest pains ... you’ve got to take care of yourself,” his wife said.