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Category Archives: Neurology

Broken Heart Syndrome Can Prove Fatal

 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.

 

Risky Business: The Brain and Behaviour in Teens

Dr. Tonmoy Sharma

“What were you thinking?” “Have you lost your mind?” These oft-repeated questions have been directed at teenagers over the millennia in response to their illogical, irresponsible and – at times – frankly dangerous behaviours. Whether taking drugs and drinking, engaging in risky sex or pulling scary stunt to impress their peers, teens have driven parents, teachers and other adults crazy with their inexplicable actions that put themselves and others at risk. So, what gives? Why do young people do the things they do with no regard for the consequences?

Many theories have been forwarded, from the fact that adolescents feel immortal and delight in defying parental authority, to youths’ need to mimic the actions of their peers and get a ‘high,’ an adrenaline rush, from misbehaving. All the above may play a role, but recent research has revealed a surprising fact. The teen brain itself may be to blame.

Research has shown that a region of the brain called the amygdala, responsible for reactions such as fear, reading social cues and aggressive behavior, develops early in adolescence.  Another area, the frontal cortex, which controls reasoning and decision-making, develops more slowly, and is still forming well into a person’s 20s. The frontal cortex helps to control the emotions of the amygdala but is not as effective at doing so until later in life, well after adolescence ends.

According to studies of brain images, scientists have found that the adolescent brain works differently than the adult brain when it comes to decision-making and problem-solving. The reactive and emotional amygdala dominates, and the logical prefrontal cortex takes a back seat. This dynamic makes teens more likely to engage in dangerous behaviors, act on their impulses, get into fights, and have accidents or falls.  As illogical as it seems, the brain’s functioning makes teens less likely to think before they act, consider the consequences of their actions, and avoid inappropriate or dangerous behavior.

The environment that teens grow up in is also important to their brain functioning. Studies have shown that the prefrontal cortex is particularly susceptible to being shaped by life experiences in adolescence, such as stress and drugs of abuse. Changes in prefrontal cortex development during this time can have long-term consequences later in life. Other research has shown that elevated levels of a stress hormone called cortisol can trigger changes in the brain during adolescence that can result in serious behavioral problems and mental illnesses. Growing up isolated or in a chaotic environment, for example, can increase levels of cortisol, triggering problems that can last into adulthood or even for life.

What is parent to do? Science has shown that preventive care is vital during adolescence to help their brains develop normally. Although strong emotions and changing moods are normal in adolescents to a point, addiction to drugs or alcohol; harming oneself (such as cutting, thoughts of suicide); or depression that does not go away are examples of behaviors that indicate a serious issue.

Protecting teens from social stressors, such as isolation and neglect, can help to lower cortisol. A safe, loving and nurturing environment can actually make the teen brain healthier. Fostering daily habits that reduce cortisol and increase ‘feel good’ brain chemical such as dopamine and oxytocin is important.

 

Healthy habits include physical activity, creating strong familial and friendship bonds, getting enough sleep and having creative outlets, such as art or music. If signs of a serious mental health and/or addiction problem surface, teens need professional therapy and social support immediately to stop the brain from developing abnormally. Research has proven that, in teens,

the brain is running the show, but a nurturing environment, social support and getting professional help when needed can place adolescents on the path to a brain-healthy adulthood.

Is the Chief Executive Officer of Sovereign Health. His research includes extensive work in the areas of psychosis and memory disorders and he has published more than 150 academic papers and book chapters in the behavioural health field of cognition.