Wednesday, June 17, 2009

Broken Heart Syndrome


Broken heart syndrome (BHS) is a weakening of the myocardium (heart muscle). It goes by other, less romantic, names including stress-induced cardiomyopathy and takotsubo cardiomyopathy. The last of these titles is derived from the, romantic, tale of a Japanese fisherman who fell in love with his octopus and upon rejection, died of a broken heart (takotsubo can be translated as ‘octopus trap.’ Also, upon reflection, I think that something along the lines of acute myocardial infarction might be more romantic than unrequited-octopus-love-induced suicide.).

Broken heart syndrome presents most commonly in post-menopausal women. Symptoms are similar to those of a heart attack – chest pain, shortness of breath, and sense of impending doom. However, unlike a heart attack, in BHS neither of the arteries is fully blocked, cardiac enzymes are not significantly elevated, muscle damage is reversible, and recovery time is quicker. (1)

Triggers of the syndrome include various forms of sudden, stressful, psychic trauma such as bereavement, abuse, or surprises (BHS may also be triggered by physical trauma or without precedent). Further increasing risk of heart illnesses are self-injurious behaviours and medical non-compliance, also associated with stress. “A sense of hopelessness, in particular, appears to be strongly correlated with adverse cardiovascular outcomes.” (2)

Major depressive disorder is, not surprisingly, associated with coronary heart disease. (3)

Just as obvious, suicidal ideation was found to be greater among widowers (females greater than males, though men more often complete suicide attempts) than married persons. But when these results were controlled for with emotional loneliness, the marital factor became insignificant. (4)

Another study looking at suicidal ideation among the bereaved also found a positive association between the two. I am in no way doubting the effect of grief on a person’s psyche and actions, but it is interesting to note that the grief-subjects were those who were survivors of a suicide victim and this may have increased the likelihood of suicidal ideation. (5)

A small but interesting study sought to examine the physiological differences between clinical depression and bereavement-induced depressive feelings citing differences in heart rate and heart rate variability. It’s difficult to say how significant these results are, but it is certainly admirable to work on distinguishing different psychiatric disorders. (6)

The remedies for depression-induced-stress-related cardiac problems are the usual treatments prescribed for psychiatric illnesses, all of which I recommend, particularly in times of stress even though it is during these times that hopelessness may lead to apathy. “These include psychosocial support, regular exercise, stress reduction training, sense of humor, optimism, altruism, faith, and pet ownership.” (2)

So it appears that although incredibly painful, potentially life-threatening, and possibly demanding of emergency attention, broken hearts are unlikely to kill you and will actually heal very quickly (two weeks at most, they say). (7)

References: 1, 2, 3, 4, 5, 6, 7

2 comments:

  1. it's as painful as it seems.

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  2. Though it may be painful, it is important to remember that the pain will subside and healing can occur.

    ReplyDelete