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Broken heart syndrome: what it is and why they warn about it on the eve of Valentine's Day

2023-02-13T13:28:20.066Z


The SAC and the FCA take advantage of the date to raise awareness about a situation that especially affects women.


Can you break a heart?

The answer given by the Argentine Society of Cardiology (SAC) and the Argentine Cardiology Foundation (FCA) is

yes

.

Through a joint statement issued on the eve of Valentine's Day, they affirm that the expression is not a legend;

It can happen and it is important to know what it is to be able

to consult in time or help

those who present these symptoms.

White's story

"Blanca, 55 years old, came to my office after 2 years of being

very distressed

because after a year of taking care of her sick husband (who had passed away 3 months ago), despite not feeling well, the paperwork and the tiredness delayed his appointment", introduces cardiologist Carolina Salvatori, adviser to the SAC's Clinical Cardiology Council.

And she continues: "When I perform the electrocardiogram, I am surprised to find a new scar on his heart (a heart attack)."

The doctor then asks Blanca if she had experienced symptoms.

The woman tells him that two days before her husband died, and in the context of hospitalization, she felt a very strong pain in her chest

with a great sense of anguish

, "thinking and justifying her ailment as a result of the stress situation." 

Blanca's is just one example of the cases that come to the doctor's office or to a guard, where after a situation of

physical stress

(surgery, intervention) or

psychological

stress (separation, mourning, dismissal from work, natural disasters or death of pets, among others), all extreme emotions for which sometimes a person can develop a heart attack.

While it's simple to measure other heart risk factors, it's not easy to measure levels of stress or sadness.

Photo Shutterstock.

What is Takotsubo syndrome or broken heart

Salvatori explains that although the most frequent cause of myocardial infarction is atherosclerotic disease, the product of modifiable cardiovascular risk factors such as arterial hypertension, dyslipidemia, smoking, diabetes, obesity, psychosocial factors, among others, or non-modifiable genetic history. or age, there is the so-called 'Takotsubo Syndrome' (also called broken heart syndrome) or

stress cardiomyopathy

.

It is a cause described relatively recently, in Japan, in

the 90's

.

It was named this way because of a domed-shaped vessel with a narrow neck used by fishermen in that country to catch octopus, since it is

the shape that the heart acquires after suffering this type of injury, where it stops and the tip

of the heart

is affected .

Broken heart syndrome, more common in women

In 85% of the reported cases they are postmenopausal women, who, after suffering an unexpected stress situation (physical or emotional) present an

excessive release of adrenaline

.

This syndrome is characterized by having a presentation similar to that of a myocardial infarction, with symptoms such as chest pain, shortness of breath, abnormal electrocardiogram, elevated cardiac enzymes, and decreased blood flow to the heart, which in this case is not due

to

the occlusion of an artery by a blood clot as in atherosclerotic disease, explain from the SAC and the FCA.

In Takotsubo Syndrome, the arteries of the heart are

almost always normal

(confirmed by a catheterization, a study that shows the interior of the arteries), but the part of the heart affected by the decrease in blood flow (usually the apex of the heart) is usually initially contract with less force.

In most cases this weakness recovers after a few weeks and the heart

contracts normally again

.

Takotsubo Syndrome presents with the symptoms of a heart attack.

Photo Shutterstock.

The role of adrenaline

From the medical societies they emphasize that it is important to take into account that when faced with a situation that our mind considers threatening, adrenaline is released immediately to prepare

us both to face

that situation (fight), and to evade or move away from it (flight).

Adrenaline has

effects on the heart

(causes tachycardia, which is the increase in pulsation) and favors a closure of the blood vessels (vasoconstriction), producing by both mechanisms a very significant decrease or directly the cessation of the blood flow that feeds the heart.

heart muscle.

"In other cases in which the situation overwhelms us, we can even

remain 'paralyzed'

or lose consciousness (syncope), as part of an ancient mechanism for coping with stress situations," explained cardiologist Julio C. Giorgini, a member of the Council for Psychosocial Aspects and the Heart and Women Area of ​​the FCA.

brain-heart connection

A study published by the American Heart Association (AHA) indicates a

higher incidence

of this syndrome in middle-aged and older women, at a rate 10 times higher than in younger men or women.

"This study showed the critical role and connection between the brain and the heart," reflected Dr. Salvatori.

The SAC and the FCA warn that it is possible to quantify cholesterol, blood pressure and blood glucose levels, but it is difficult for us to quantify how

stressed, depressed or sad

a person is.

Without a doubt, they emphasize, the heart and emotions are related and achieving good stress management is as important as treating 'classic' factors such as hypertension, tobacco use, high blood sugar or cholesterol or being overweight.

Another important fact to highlight is that

after the age of 50

the incidence of cardiovascular disease in women increases gradually with aging and even exceeds that of men, since the protection that female hormones generate over the cardiovascular system is lost.

However, replacement therapies after menopause have not shown

cardiovascular

protection .

"Although the popular belief is that the main cause of death in women is cancer of gynecological origin, this is not the case," Salvatori clarified.

"Cardiovascular disease is

the leading cause of death in women

, affecting 1 in 3 women, versus mortality from gynecological tumors, which occurs in 18% of cases," concluded Dr. Giorgini.

This is not a minor fact, since women carry out their annual gynecological check-ups, but they

do not usually check their heart

.

Many times, even the symptoms of a heart attack are confused and minimized thinking that it is just stress.

In another recent 2021 AHA review, the impact on cardiovascular disease of conditions such as anxiety, unpleasant emotions such as anger, anger, sadness, diseases such as depression, or even being pessimistic was evaluated.

It was shown that, together, they increase the risk of having a heart attack by about 30%.

Outbursts of anger or rage increase the chances of heart attack, stroke, or malignant cardiac arrhythmias by up to 20%, with most of these episodes occurring within 2 hours of

the rage or outburst

.

Major depression occurs in 5 to 7% of the general population, but reaches up to 15% in people who have had a heart attack.

"On the other hand, also taken as a whole, beneficial attitudes, such as having a positive outlook on life, optimism, meditation and mindfulness reduce the risk of suffering a coronary event by 18%," Giorgini said.

Valentine's Day: the importance of physical contact

Finally, within the framework of Valentine's Day, medical societies point out that the relationship between physical contact and the heart deserves a separate paragraph.

"There are studies that have shown that

caresses and hugs

generate a safe environment, a greater neural connection between two people and greater activation of the ventral portion of the vagus nerve, strengthening bonds and secure attachment (both in children and adults)" Giorgini commented.

And he added that at the cardiovascular level, activation of the ventral vagus nerve (located at the level of the belly) stimulates parasympathetic action, increasing cardiac variability and coherence and decreasing heart rate (less arrhythmias and tachycardia) and blood pressure (less hypertension). .

As a result of all this, he concluded: "Casses and hugs are good for the heart."

***

Do you want to know more about the impact of stress and emotions on the heart and brain?

These notes may interest you:

➪They warn that economic crises increase the risk for the heart: how to take care of it

➪Stroke symptoms can be different in men and women: how to recognize them

➪Broken heart syndrome: what role does the brain play?

➪Can anger or emotional upset trigger a stroke?

➪"Mindful walking", the walk to go through moments of anxiety: how to do it step by step


***

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