Broken Heart Syndrome Affects Women The Most
It was the Japanese who first identified the problem in the 1990s, showing that a sudden shock or emotional stress can cause the heart to begin behaving as though it’s had a heart attack, even though there is usually no permanent damage. Now researchers at the University of Arkansas have identified that Broken Heart Syndrome is more common in women than in men.
Basically, what causes Broken Heart Syndrome is a sudden rush of hormones and adrenaline, usually from an emotionally linked event. Parts of the heart then enlarge temporarily, causing symptoms much akin to a heart attack, only without the normal physical factors such as blocked arteries and muscle damage in a clinical heart attack.
Broken Heart Syndrome can be caused by both negative or positive events, anything from winning the lottery to a car accident or sudden death of a loved one, have been shown to set it off.
The new research shows women as much as seven times more likely to be affected and older women are at greater risk than younger ones. The researchers presented the information Wednesday at the American Heart Association conference in Orlando, Florida.
Dr. Abhiram Prasad, a Mayo Clinic cardiologist who was not associated with the study, told AP that while heart attack and heart disease, hit men more often and earlier in life than women :
“It’s the only cardiac condition where there’s such
a female preponderance.”
Dr. Abhishek Deshmukh, a cardiologist at the University of Arkansas who has treated women with broken heart syndrome, became curious about just how gender-specific the condition was, prompting the new research. Using a federal database that included data from roughly 1,000 hospitals, Deshmukh found 6,229 cases of broken heart syndrome in 2007. Of those, only 671, just under 11% were in men.
Broken Heart Syndrome (BHS) also called stress cardiomyopathy, is triggered by extreme and sudden emotional trauma. Reported triggers have included unexpected news of a death, domestic abuse, armed robbery, and even a surprise party. The condition manifests with symptoms suggesting an acute heart attack (severe pressure-like chest pain, shortness of breath, and a sense of impending doom).
When first evaluated, patients with BHS are initially thought to be having massive heart attacks. However, the changes on their ECGs are not typical for a heart attack, and the cardiac enzyme tests that are supposed to confirm a heart attack are found not to be significantly elevated. Furthermore, when taken to the catheterization laboratory, their coronary arteries are found to be normal (whereas in true heart attacks, one of the coronary arteries would have been completely occluded). And finally, many of these patients are found to have a peculiar type of heart muscle weakness (or cardiomyopathy) on echocardiography, where the apex of their left ventricle “balloons” outward in an unusual fashion.
Many patients with BHS are initially in severe heart failure, and require aggressive and intensive cardiac care. With appropriate care, however, not only do they survive, but also their cardiomyopathy completely resolves within a few days to weeks.
He found women had about 7.5 times the risk of Broken Heart Syndrome than men; in people under 55, women were at 9.5 times greater risk than men. Women over 55 were also three times more likely to suffer broken heart syndrome than younger women. The exact reason for the gender disparity is not known, perhaps men are better at dealing with the physical stress from an emotional event, or perhaps men simply get less emotional. They told the AP that :
The research also shows about 10% of those affected having a second episode at some point in their lives, but they usually return to full heart function without permanent damage or need for follow-up treatment. It seems that the best way to mend a broken heart is just by giving it a little time.
Researchers in Germany and Canada identified 256 cases of stress cardiomyopathy between January 2005 and October 2010 from seven different hospitals in Europe and North America.
Patients ranged in age from 30 to 90. The average age was 69.
As expected, most of the affected patients, 81%, were postmenopausal women. But 8% of cases were in women younger than age 50, and 11% occurred in men.
Only two-thirds of study participants were able to identify something that triggered their symptoms.
For 30%, the cause was emotional, and included the death of a friend, pet, or relative, interpersonal conflict, anxiety, anger, or the loss of a job.
For 41% of study participants, the cause was physical. Top physical stressors reported in the study included surgery, breathing trouble like COPD, asthma, or bronchitis, and chemotherapy.
“Despite careful history taking,” the researchers write, “only two-thirds of patients had a clearly identifiable preceding stressor.”
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Written by Rupert Shepherd