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Broken Heart Syndrome

DEFINITION

Broken Heart Syndrome is the common name of a temporary malfunction of the heart due to physical or emotional stress. The symptoms of broken heart syndrome often mimic a heart attack with similar chest pain. Broken heart syndrome is also called Takotsubo cardiomyopathy and stress cardiomyopathy. Broken heart syndrome is started by a sudden release of stress hormones that cause the heart to temporarily enlarge and not function properly. The release of stress hormones can be caused by any type of stressor such as the death of a loved one, an unexpected medical diagnosis, a car accident, major surgery, or the loss of a large amount of money. In a heart attack, chest pain is caused by blocked arteries in the heart leading to decreased blood flow to the heart muscle. In broken heart syndrome, these blockages are not present, though blood flow may still be somewhat reduced. Risk factors for broken heart syndrome include being a woman, being older than 50 years of age, having a major life stressor, and having had broken heart syndrome before. Most people recover within a week from broken heart syndrome. Complications of broken heart syndrome include abnormalities of the heartbeat and decreased pumping of the heart leading to backup of fluid into the lungs. Rarely, broken heart syndrome can cause death. Nobody is really sure why some people have trouble with their hearts after the release of stress hormones while others don’t.

SYMPTOMS
Chest pain, difficulty breathing

DIAGNOSIS
Your doctor will begin by talking to you about your symptoms and doing a physical exam. Your doctor will likely want to do an electrocardiogram (EKG or ECG) which involves placing small stickers on the skin of the chest then hooked up to a machine. The printout from this machine shows your doctor or cardiologist an electrical picture of the function of your heart. Your doctor may also want to take a picture of your chest with a chest x-ray. Your doctor will probably want to check your blood both to see how you electrolyte levels are and to make sure that you aren’t having a heart attack by checking heart enzyme levels that increase during a heart attack. Your doctor will likely recommend doing an echocardiogram or ultrasound of the heart to see how well the heart is pumping. You may also have a cardiac catheterization which involves feeding a thin catheter through a vein in the leg up to the heart where dye is shot into the arteries to see if the heart vessels are blocked. A cardiac catheterization can also show the pumping function of the heart.

TREATMENT
Treatment for broken heart syndrome usually just involves watching and waiting to make sure that things return to normal. Most of the time, your doctor will prescribe medications for the blood pressure and to protect the heart while you are in the hospital waiting to recover including angiotensin converting enzyme inhibitors (ACE-inhibitors), beta-blocker, or diuretics. These medications can ease the burden on the heart temporarily. You should talk with your doctor about your symptoms and treatment options.

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