Slashdot Mirror
Hearts Actually Can Break
DesScorp writes "It seems that there's a grain of truth to one old wives' tale; it turns out that you really can die of a broken heart, especially if you're a post-menopausal woman. The Wall Street Journal reports on a phenomena called 'broken-heart syndrome,' which often occurs after great emotional distress. Quoting: 'In a conventional heart attack, an obstructed artery starves the heart muscle of oxygenated blood, quickly resulting in the death of tissue and potentially permanently compromising heart function. In contrast, the heart muscle in broken-heart-syndrome patients is stunned in the adrenaline surge and appears to go into hibernation. Little tissue is lost.' In the article a doctor notes, 'The cells are alive, but mechanically or electrically disabled.' Documented cases track heart attacks in people with seemingly healthy hearts after the grief of the death of a loved one. Intense feelings can cause the heart actually to change shape. Doctors call this 'tako-tsubo,' after the Japanese phrase for 'octopus trap,' so called because the syndrome was first identified by a Japanese doctor who noticed the strange shape in the left ventricle. Doctors note that while strong emotions like grief are usually associated with the syndrome, stress or a migraine can also trigger such heart attacks."
Try being married for 27 years to a serial adulteress. That's REAL pain.
A man can hit me, punch me, kick me, stab me, cut me, shoot me, but only a woman can hurt me.
Free Martian Whores!
My great great grandmother went out that way. They immigrated from Scotland together, ran away to america as teenagers since her father wouldn't let them marry. Two days after my great great grandfather died, she passed away. They couldn't find a reason.
-- 4 8 15 16 23 42
I am an interventional cardiologist, and I see a new case of Takotsubo cardiomyopathy about once every 3-4 months.
It really is strongly associated with high levels of stress, and most individuals (who reach the hospital) recover within a month.
Unfortunately, when they present to the hospital, they appear as a very large heart attack, with chest pain, shortness of breath, congestive heart failure (fluid in the lungs due to a weak heart), low blood pressure and EKG changes consistent with a heart attack. The coronary arteries are normal, and the heart muscle has a pathonemonic shape. The nice thing is that if you can support them over the first couple days in the hospital, they do recover and go back to normal.
The wikipedia article on the topic is quite good, by the way.
Help! I'm a slashdot refugee.
when they present to the hospital, they appear as a very large heart attack, with chest pain, shortness of breath, congestive heart failure (fluid in the lungs due to a weak heart), low blood pressure and EKG changes consistent with a heart attack.
GP here. Perhaps I didn't express my point clearly enough:
With such presenting signs, there is NO WAY such a patient is going to be "sent home" anyway. So frankly the original article is just a bunch of sensationalist writing trying to imply something new about things that we already know. OK, it's nice to have a name for it. Yes, there's probably a constellation of signs that differentiate it from the "non-Takotsubo" AMI which you as a specialist know all about. The prognosis is probably different, from what you imply. However my point is we've known that stress is one of many risk factors for AMI for years. What's new?
The nice thing is that if you can support them over the first couple days in the hospital, they do recover and go back to normal.
I should hope that any patient presenting dyspnea and left side heart failure gets all the support (s)he needs anyway, with or without elevated troponin levels and ST alterations...
Me I'm thinking of the hordes of people who love to clog up emergency rooms because they've "discovered" a new disease and they think they have it. Kind of like the recent H1N1 epidemic. I bet more people died in the hallways of packed emergency rooms of (name your favorite common pathology) than H1N1 last year while medical staff screened everyone who claimed to be sick. I think some medical information should stay within the medical community. Like pilots are told on obtaining their license: "congratulations, now you know just enough to kill yourself".
Seven puppies were harmed during the making of this post.