Its symptoms are similar to a heart attack. More women with “broken hearts”

The number of “brokenhearted” women is increasing. This is a condition known as Takotsubo syndrome (TTS) or stress cardiomyopathy. Cardiomyopathy is a rare heart disorder that results from emotional or physical stress. Its symptoms are similar to a heart attack.

More and more women have “broken hearts”, report scientists from Cedars-Sinai Medical Center. Especially – 10 times more than young women and men – women from the age of 50 suffer. No, it’s not about a heartbreak, but about the so-called Takotsubo syndrome (TTS), also called broken heart syndrome or stress cardiomyopathy.

Data on 135 people diagnosed with this disorder in 2006-2017, in addition to confirming that women get sick more often, it showed that in female people aged 50-74, the number of cases increases 10 times faster than in other groups. Luckily, this rare condition can manifest as sudden chest pain, shortness of breath, and it may feel like a heart attack. The arteries in the heart can narrow, but unlike with a heart attack, the vessels are not blocked. Often the left ventricle is enlarged.

No therapy, but good prognosis

Sometimes medications are given to reduce the workload on the heart and lower the risk of this type of happening again. Rarely, but still possible, death or complications occur – arrhythmias, pulmonary edema, hypotension, heart failure or blood clots. The cause is believed to be stress and possibly the related adrenaline rush into the bloodstream. Therefore, the disease may be preceded by a difficult mental or physical experience – the death of a loved one, an accident, a strong argument, acute illness, or surgery. Less frequently, it may be associated with certain drugs or illegal substances, such as methamphetamine or cocaine. Unfortunately, targeted treatment is lacking, but fortunately, patients usually recover within a few weeks.

COVID-19 was heartbreaking

When considering the causes of the disorder, it is not surprising that Cleveland Clinic researchers found a significant increase in the incidence of the pandemic during the current pandemic. – The COVID-19 epidemic has caused stress on many different levels, all over the world. People are not only worried about their own health or that of their families, but they have to deal with economic, emotional and social problems, as well as often loneliness and isolation – notes Dr. Ankur Kalra, author of the publication that appeared in the journal JAMA Network Open . People diagnosed with Takotsubo syndrome were also COVID-19 free. – Stress can cause physical effects in our body, including the heart, as shown by the increasing number of cases of stress cardiomyopathy – emphasizes the specialist.

According to scientists, it is important to take care of yourself properly. The same certainly applies to other stressful situations, not just epidemics. As the pandemic evolves, caring for yourself in this difficult time is critical to your heart health and overall health. If someone is feeling overwhelmed by stress, it’s important to consult a doctor. Exercise, meditation, distancing yourself with family and friends and precautions can help reduce tension, said Dr. Grant Reed, one of the study’s lead authors.

Dangerous disasters

In turn, researchers from the University of Arkansas after looking at over 20. Takotsubo syndrome patients detected a more than doubled incidence in Vermont affected by devastating Hurricane Irene. They also recorded an increase in the number of cases in Missouri haunted by the Tornado.

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‘Our results indicate that two disasters, one in Vermont and one in Missouri, could potentially increase the incidence of Takotsubo cardiomyopathy in these regions,’ notes lead author of the study, Dr Sadip Pant. – Doctors and other emergency department personnel should have this possibility in mind, as they are on the first line of aid for patients in the event of natural disasters – emphasizes Dr. Pant.

Much depends on the brain

The disorder is still poorly understood, but research is revealing more information. For example, researchers at Massachusetts General Hospital and Harvard Medical School found that people with a particularly stress-responsive amygdala are at greater risk of contracting the disease. It is a center in the brain involved, inter alia, in processing emotions. Slightly atypical brain activity in people predisposed to developing the disorder was also accompanied by changes in the bone marrow.

‘These results provide further evidence of the damaging effects of stress-related biological processes on the bloodstream. Discoveries such as this indicate the need for further research into the effects of stress reduction or the use of drugs that affect certain parts of the brain and heart, says Dr. Ahmed Tawakol, who led the study. – In the meantime, when facing patients under chronic stress, doctors should consider the possibility that reducing stress may benefit the bloodstream – emphasizes the expert.

Too strong joy

It turns out that not only difficult situations are dangerous. When researchers from the University Hospital in Zurich analyzed data on nearly 2 of patients with the disorder, in nearly 500 of them, they identified a clear, easily identifiable emotional factor. 96 percent of these people experienced a difficult experience, but in 4% the illness was preceded by a joyful event, for example a wedding, the birth of a grandson, or even a birthday or the victory of a favorite rugby team. – We have shown that TTS triggers can be much more varied than previously thought. A person with TTS is no longer a typical patient with “broken heart syndrome”, and the disease may also be preceded by positive emotions, says the author of the study, Jelena Ghadri, who founded the world’s first International Takotsubo Registry (http://www.takotsubo-registry.com) .

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– Doctors should be aware of this and take into account that patients brought to the emergency department with symptoms of a heart attack such as chest pain and difficulty breathing, but after a happy event and positive emotions, they may suffer from TTS, as well as patients with similar symptoms but after a negative emotional event. Our results extend the clinical spectrum of TTS. They also suggest that happy and sad events can affect similar emotional paths ultimately leading to TTS – adds the specialist.

Hope for a drug

Although there are no specific drugs yet, scientists are still looking for them. A group at Monash University reported last year about a drug that may help treat ailments. So far, in studies in mice, the team has shown the strong effects of suberanilhydroxamic acid. It is a compound that affects the activity of various genes and is currently used in the treatment of certain types of cancer.

– We showed for the first time that the drug has a protective and therapeutic effect important for heart health. It not only slows down damage to the heart, but also reverses damage caused by stress – informs Prof. El-Osta himself. – This preclinical study shows a new standard of prevention and treatment using a cardioprotective drug that affects genes in the heart – adds the expert.

It’s a good news. Meanwhile, it is worth remembering that chest pain, rapid irregular heartbeat, shortness of breath, also after a stressful event, are a signal to contact a doctor immediately.

Author: Marek Matacz

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