You’re having chest pain and can’t catch your breath. Surely you’re having a heart attack, right? While you should certainly go to the emergency department right away, your symptoms may end up being linked to something else that’s typically less life-threatening: broken heart syndrome.
has some of the same symptoms as a heart attack. But this temporary condition (also called takotsubo cardiomyopathy or ) differs in that there is no evidence of blocked arteries, as with a heart attack. Instead, it’s a weakening of the heart muscle that may be caused by a surge of adrenaline or other stress hormones. The condition is usually brought on by a physically and/or emotionally stressful event, such as job loss, a natural disaster, major surgery or sudden illness, a big change in a relationship — even a surprise party. In my practice, I’ve seen cases that occurred while a pregnant woman gave birth and in the midst of a custody battle in court.
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While broken heart syndrome seems to be more prevalent in women, research has not yet shown whether that’s because more women actually have the disease or whether there is a difference in presentation between men and women.
Heart Attack or Broken Heart?
It can be difficult to tell whether a patient presenting with what looks like a actually has broken heart syndrome. In every case, a good start to understand the root of the problem is a careful history and examination. Usually, I’ll do an electrocardiogram and lab tests, but it’s important to note that these may look the same in patients having a heart attack and those with broken heart syndrome. Often, the only way to tell is with a cardiac catheterization. In this procedure, a tube is inserted into an artery and reveals if any coronary arteries are blocked. Someone with broken heart syndrome won’t show severe blockages in the blood vessels going to the heart.
The good news is that if broken heart syndrome is the diagnosis, the prognosis is very good. In most cases, after the initial episode, the heart recovers completely in four to six weeks with medical treatment.
Of course, just because you get the “better” diagnosis of broken heart syndrome doesn’t mean it can’t be a big problem. Some people can experience severe, short-term muscle failure. And in rare cases, the condition can be fatal if arrhythmias or cardiogenic shock (where the weakened heart can’t pump enough blood) occur alongside it. Although factors like advanced age and additional medical problems can increase the risks of these consequences, there’s a small risk of dire complications in young, healthy people.
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Straightforward Treatment
Fortunately, treatment is fairly straightforward and short. While broken heart syndrome mostly gets better on its own, generally over four to six weeks, I do often prescribe a few medications to speed up the healing process. For acute cases, I’ll have patients take something to control their and keep their lungs from filling up with fluid. I may give them a beta blocker or ACE inhibitor to slow down the heart and make it work less while they recover. For the most part, medications only need to be taken for three to six months after an incident. After a few days of symptoms, most people will start to notice improvement. And patients who have had broken heart syndrome once aren’t likely to get it again — in most cases, it only occurs once.
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Finding the Trigger
Once the diagnosis of broken heart syndrome is established, rather than something more serious, I try to find out what may have caused the symptoms that brought the patient to the . Sometimes, a patient is mystified about what could have triggered the onset. That’s when it can be helpful to speak with a partner or : They can often identify and share the likely cause, especially if it’s emotional.
When it comes to prevention, I encourage my patients to take steps to manage any stressors in their life, such as through exercise, maintaining a and engaging in relaxing activities, such as stretching, taking a hot bath or shower or getting a good night’s sleep. Such activities have the added benefit of boosting your overall health.
While a diagnosis of broken heart syndrome can be comforting, it’s important not to self-diagnose. If you have worrisome symptoms, such as chest pain, shortness of breath or weight gain, seek care as soon as you can.
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