By Dr. Aseem Dhall It’s common that we get to hear the unfortunate news of a couple who died one after the other due to grief. Or, someone who could not cope up with the tragic news of financial loss or any kind of personal loss. These deaths are very often result of a “broken heart syndrome“, also known as stress cardiomyopathy or takotsubo cardiomyopathy, a condition that’s often brought on by stressful situations. Most people suffering from “broken heart syndrome” have normal coronary arteries and do not show any major blockages or clots. Infact, patients who suffer cardiomyopathy, their heartmuscle becomes suddenly weakened or stunned. And, there’s a temporary disruption in the heart‘s normal pumping function but only in one area that leads to change in shape of heart. Whereas the remaining heart functions normally or with even more forceful contractions. Perhaps the reason this condition is also called as apical ballooning syndrome. The symptoms of a broken heart syndrome are usually treatable, but only if diagnosed on time, and it at times reverses itself in a span of few days or weeks. Symptoms Broken heart syndrome symptoms very often mimic a heart attack as such people often have sudden intense chest pain and experience shortness of breath. These symptoms begin just a few minutes to hours after exposure to the unexpected stress. Other symptoms may include: * Fatigue, feeling lethargic, sleepy * Electrocardiogram abnormalities are very identical to those of a heart attack * No evidence of coronary artery obstruction * Abnormalities in the left ventricle * Ballooning of the left ventricle Common Causes Though the exact cause of a broken heart syndrome is unclear, it is believed that a surge of stress hormones, such as adrenaline, might temporarily damage the heart of some people, especially women. But how exactly these hormones might hurt the heart or whether something else is responsible too isn’t completely clear. However, a broken heart syndrome is often accompanied by an intense physical or emotional event. Some potential triggers of broken heart syndrome are: * News of an unexpected death of a loved one * A frightening medical diagnosis * Domestic abuse * Losing/winning a lottery * Having to perform publicly * Job loss * Divorce * Physical stressors, such as an asthma Broken Heart Syndrome Versus Heart Attack Heart attacks are generally caused by a complete or partial blockage of a heart artery due to a blood clot formation in the wall of the artery. While in a broken heart syndrome, the heartarteries are not blocked, although flow of blood in the arteries of the heart may be reduced. And there are a number of known risk factors for broken heart syndrome, which may include: * Sex; as the condition is believed to affect women far more often than men. * Age is another criterion. Broken heart syndrome affects mostly people who are older than 50. * People who have a history of a neurological condition such as a head injury or a seizure disorder (epilepsy) have a greater risk of broken heart syndrome. * Any psychiatric disorders such as anxiety or depression, etc. Diagnosis and Treatment In some cases broken heart syndrome proves to be fatal. However, most people who experience broken heart syndrome recover over a period of time and don’t have long-lasting effects. But in some cases it may lead to other complications such as : * Pulmonary Edema * Low blood pressure (hypotension) * Disruptions in the heartbeat * Heart failure However, if the cardiologist suspects of a broken heart syndrome, he/she will prescribe tests such as ECG which helps to detect irregularities in the heart‘s rhythm and structure, a chest XRay, Cardiac MRI, Echocardiogram and coronary angiogram, etc. Echocardiogram helps to find out if the heart is enlarged or has an abnormal shape. Though there’s no standard treatment for broken heart syndrome, change of environment often helps to divert mind of such patients. Once it’s clear that broken heart syndrome is the cause of underlying symptoms, the doctor will prescribe heart medications. It’s mainly treated with diuretics, agents that improve heart muscle contraction, and other therapies but there’s no surgery that’s required for the treatment of this disorder. And most of all its important to keep the patient away from any physical/emotional stress that may have played a role in triggering the disorder. Is a Director and Head, Saroj Cardiac Sciences, ISIC ,Vasant Kunj.