Broken Heart Syndrome - Is it for real?

No sooner she received the text from her boyfriend with whom she had been in a relationship for the last 8 years that he wants a breakup; she suddenly developed a discomfort in her chest, a pain so intense as if her heart has been shattered into hundreds of small pieces. This is not something from some old romantic fiction, but what she experienced was Broken Heart Syndrome. And it is for real! Let us learn more about what a broken heart syndrome is and why it happens.

What is Broken Heart Syndrome?

Broken Heart Syndrome is a non-ischemic cardiomyopathy (cardio: heart; myopathy: disease or dysfunction of muscle; ischemia: a condition where the blood supply to an organ is compromised or interrupted leading to organ damage and dysfunction. In Broken Heart Syndrome, thus there is dysfunction of the cardiac muscle without any interruption in the blood supply to the muscle) that typically occurs in older women after sudden intense emotional or physical stress. As such it is also known as Stress Cardiomyopathy. There is a temporary weakening of muscular portions of the heart, especially the ventricles (the heart chambers that pump the blood to the body), as such the apex of ventricles dilates and the base constricts, resembling a takutsubo (a narrow-necked jar used to trap octopuses in Japan). That is why broken heart syndrome is also known as Takutsubo Syndrome.

Broken Heart Syndrome mimics a Heart Attack or Myocardial Infarction, presenting with chest pain and ECG changes, but the difference is there is no actual interruption of blood supply to the heart muscle.

The first case was reported in Japan by Dr. Sato in 1991. However, it was not until 2005, the condition received widespread recognition as many such cases were reported by then.

What is the mechanism behind Broken Heart Syndrome?

Although many theories have been put forward; but the most plausible one is the Catecholamine Induced Mycocytes (Muscle cells that form the heart) Injury. Stressful situation floods the blood with  neurotransmitters called Catecholamine (like adrenaline, non-adrenaline). High level of catecholamines in the blood can be toxic to the heart muscle cells, causing damage, thus leading to its dysfunction and finally Broken Heart Syndrome. Other hypothesis includes transient vasospasm of coronary arteries (arteries that supply blood to the heart muscle) and mid-ventricular obstruction (where there is a thickening of the middle portion of the ventricle, thus obstructing blood outflow).

Although there is no proven therapy for this condition, multiple drug therapies are available to treat the symptoms and the prognosis of this condition is usually good as well.

So, next time if you have a heartache due to some emotional reason, remember that it could be Takutsubo Cardiomyopathy or "Broken Heart Syndrome"!

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