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Not only love can break your heart: What is broken heart syndrome? Causes, symptoms and how to treat it

2022-05-27T10:36:46.400Z


Joe Garcia, the husband of Irma Garcia, one of the two teachers killed in the Texas massacre, died at home of a heart attack in what relatives say may be a case of broken heart syndrome.


Husband of teacher killed in Uvalde massacre dies 0:49

(CNN) --

Yet another tragedy has occurred after Tuesday's devastating shooting massacre at Robb Elementary School in Uvalde, Texas.

Joe Garcia, the husband of Irma Garcia, one of the two teachers killed in the Texas massacre, died at home of a heart attack in what relatives say may be a case of broken heart syndrome.

The couple have four children, according to the elementary school's website.

"I truly believe that Joe died of a broken heart from losing the love of his life for over 25 years was too much to bear," Irma Garcia's cousin, Debra Austin, wrote in a post on the family's GoFundMe site.

Husband of teacher killed in Uvalde massacre dies 0:49

How does it feel to be heartbroken?

It's weird, but you really can die from a broken heart.

A sudden emotional shock, such as the death of a loved one, can cause the heart to take on an unusual oval shape, making it unable to do its job.

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"When a person first enters the hospital, the heart can look terribly weak. It may barely be pumping. In a severe case, they would be in shock in the intensive care unit and without medical attention they would not survive," said Dr. Dr. Ilan Wittstein, assistant professor of medicine at Johns Hopkins Medicine, who published one of the first articles on broken heart syndrome, also called stress cardiomyopathy.

broken heart syndrome

Yet when Mary Brittingham's heart first broke at age 53, and then again at ages 56 and 69, it had nothing to do with losing someone near and dear to her.

"I wasn't heartbroken over a tragic love story. The first one was a surprise, a shock, in fact," said Brittingham, a former law professor at Georgetown Law School.

"The second was out of anger, and the third was out of fear."

It was 2006. Brittingham had been told to prepare a quick toast to colleagues who were to be honored at a Georgetown faculty party.

She suddenly, she heard the presenter say, "Tonight we're going to hear from three speakers, for about 15 minutes each. And our first speaker is Mary Brittingham."

  • 'Broken heart syndrome' increased during covid-19 pandemic, small study suggests

Mary Brittingham, with her dog Alfie, has experienced three episodes of broken heart syndrome.

"It was a total WHAT?" moment, he recalled.

"I was completely in shock. Was I supposed to get up and have a speech about my beloved colleagues ready? All I had was two lines prepared! And suddenly I felt a kind of crushing pressure in my chest. It was very painful, it I put it down to anxiety."

Dazed and sore, Brittingham managed to get to the stand and speak for a few minutes: "I must have said some significant things because I laughed a little," she said with a smile.

But since the pain did not subside as the night progressed, she decided to go to the hospital herself, fearing that she had suffered a heart attack.

"My heart enzymes were up, so they did an image and I had heart failure," he said.

“My father died of heart failure at the age of 36.

So I thought, 'Oh, this is it.'

But it turned out I didn't have a heart attack or heart failure, I had broken heart syndrome."

The broken heart has an unusual shape

Wittstein first encountered stress cardiomyopathy as a young attending physician in a coronary care unit in 1998, when he had three unusual cases in a row.

"I saw three patients in a row who had experienced some kind of emotionally stressful event. The first was the death of their mother, the second was a terrifying car accident, and the third was a surprise reunion. Yet each one came to the hospital with results. very similar echocardiograms," Wittstein said.

The images showed that the left ventricle of each of their hearts, which is the main pumping chamber, had swollen into a strange shape that was eerily reminiscent of a takotsubo, a pot used by Japanese fishermen to catch octopuses.

Dubbed "takotsubo" cardiomyopathy when it was first identified in Japan in 1990, the syndrome was not widely known in the United States and may have often been misdiagnosed, Wittstein said.

Symptoms like sweating, chest pain and shortness of breath can be the same as those of a heart attack, he said.

But unlike a heart attack, which is usually caused by blocked arteries, these early patients had "normal, pristine coronary arteries," with little or no evidence of cholesterol and plaque.

Even stranger: Even though blood tests showed extensive injury, the women's heart muscles did not remain altered or permanently damaged as in a heart attack, Wittstein said.

For many patients, function returned to normal within days or weeks.

"In the early years we were amazed at how quickly we would see hearts perk up again. It's almost like they're waking up," he said.

“I remember people who were sent to our center because they thought they would need a heart transplant.

And a week later they are home.

"Back then it was completely new, but once you recognized the clinical features of the syndrome, it started showing up everywhere," he said.

Wittstein and his team began studying the phenomenon and published one of two seminal papers in 2005.

"We gave it the nickname 'broken heart syndrome' because at the time no one in medicine believed that emotions could have such a dramatic impact on the human heart. We wanted to raise awareness," Wittstein said.

  • A South Carolina man died of a heart problem while burying the woman he strangled, deputies say

What are the causes of a broken heart?

Today, science still doesn't know precisely why broken heart syndrome occurs, or why some people have repeated episodes, Wittstein said.

"We think it has to do with a dysfunction in the body's fight or flight response, the release of chemicals like adrenaline, noradrenaline and dopamine that the body uses to prepare us to run away or stand up and fight," Wittstein said.

About 2% of people seen in the ER for a heart attack may have the syndrome, according to estimates, and a 2020 study found cases are on the rise, especially among women.

The rise in diagnosis may simply be due to increased awareness among doctors of the syndrome, Wittstein said.

Almost all people who have had episodes of broken heart syndrome have been women, he said, especially postmenopausal women who now lack estrogen.

"When you actually inject estrogen into a blood vessel, the blood vessel dilates, it gets bigger. So estrogen is a very important mediator of how blood vessels work in women," Wittstein said.

"In fact, studies have shown that her risk of broken heart syndrome increases fivefold after age 55 if she's a woman."

Today, doctors know that only a third of all cases are related to emotional shock, Wittstein said.

Two-thirds are caused by physical triggers, such as severe pain, asthma attacks, seizures, stroke, high fever, low blood sugar, surgery, and pneumonia.

"We know that of all the physical triggers that can cause this condition, pneumonia is one of the most powerful," he said.

That's a concern during the pandemic, Wittstein added, because Covid-19 damages the lungs and also causes microvascular function, where the body's small blood vessels don't work properly.

Damage to those small blood vessels around the heart is another theory for the condition.

"When we're under stress, we want more blood to get to our heart and help the body respond, right?" Wittstein said.

"But with broken heart syndrome, we think the rush of adrenaline causes the small blood vessels in the heart to constrict instead of dilate, temporarily reducing the amount of blood reaching the heart."

  • What you should know about using aspirin to prevent heart problems or strokes

Surviving broken heart syndrome

When Mary Brittingham felt a familiar pain in 2009, she knew she was having another attack.

It was three years after her first episode, and this time she was in the middle of a heated argument with another lawyer.

"That's my telltale sign, this crushing feeling just below my breastbone radiating through my chest into my neck," she said.

"And then I know, 'Oh my God, this isn't anxiety or indigestion.' This is a real thing."

The third episode happened a decade later when her beloved Alfie was threatened during a walk.

"For five minutes, I dealt with it, and then I went into the house, closed the door, and my chest started to fall apart," he said.

"Now, I had retired and done all sorts of things to reduce stress in my life. And I thought, I'm almost 70 years old, am I going to die in the next (attack)?"

By this time, Brittingham had sought out Wittstein as his physician and came to him with his concerns.

"I asked her, 'How do I explain this to people who are going to think I'm fragile? I'm not really. I feel pretty strong.' She told me that being fragile had nothing to do with it and that one woman had eight episodes without dying," he said.

"My favorite story he told me to make me feel better was about a woman who was camping with her husband and decided to dye her hair while he was out fishing," she added.

"A tent started blowing up and she had to go and deal with it before she could wash out the dye. All she could think about was what color her hair would be."

Wittstein picked up the story: "And she had an episode of broken heart syndrome," he said.

"It's strange, when we started describing this, we thought it had to be triggered by a massive tragedy, like the death of a loved one or a near-fatal car accident," he said.

"What we've seen over the years is that it's not really true. Some of the triggers can seem pretty minor."

Source: cnnespanol

All news articles on 2022-05-27

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