Broken Heart Syndrome

Few adults would not know, or know someone who has had a ‘broken heart.’ It is also unlikely that many do not know that shocking news, for example of the unexpected death of a loved one could also result in a heart attack. Yet, medical literature only recognized it recently. Some researchers have termed it apical ballooning syndrome (ABS), characterized by a severe, dysfunction of the left ventricle, after emotional or physical stress.

The results of their studies, presented at the American Heart Association scientific sessions in Chicago have revealed more about this condition, often diagnosed in middle age and elderly women. These researchers at Mayo Clinic in a retrospective review of 100 successive patients with ABS confirmed by angiography found that 10% of these patients had a recurrence within four years. They also found that patients whose ABS emotional stress induced had a better chance of survival than those induced by physical stress, seventeen of a hundred of which latter died during follow-up.

A related study examined perfusion of the heart musculature in 51 women with ABS and 14 controls, about two-thirds of the former noted to have abnormal perfusion due to malfunctioning of the small vessels supplying the heart, the worse this malfunctioning, the higher the risk of myocardial damage. The researchers suggested that these findings indicate ABS might be due to abnormalities of blood flow to the heart, or of receptors in heart muscles.

Earlier, researchers at John Hopkins in a study published on February 10, 2005, online in The New England Journal of Medicine, found that sudden emotional stress could cause serious but reversible heart muscle injury resembling a typical heart attack, and termed the condition, stress cardiomyopathy a.k.a ‘broken heart’ syndrome. They noted its common misdiagnosis for a massive heart attack. In fact, what has happened is a sustained increase in adrenalin and other stress hormones, which could be toxic to the heart, temporarily compromising its functioning.

However, they also noted no blockage of heart vessels, or as seen typically in heart attacks, elevation of cardiac enzymes in the blood released by damaged heart muscle, and magnetic resonance imaging (MRI) scans did not show irreversible damage to heart muscles. Indeed, the Mayo Clinic researchers also noted that the symptoms of ABS and myocardial infarction (heart attack) are similar, although the former is much more uncommon.

Genetic predisposition might play a part in ABS, according to the researchers who noted that a patient whose angiogram showed no blockage of the arteries had heart muscles that looked like those of someone who had a heart attack. They recommended therefore, treating ABS patients as those who have had a heart attack are.