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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."
Hmm... According to this 2005 article, Dr. Ilan Wittstein came to the same conclusion after conducting a study:
http://findarticles.com/p/articles/mi_m1355/is_11_107/ai_n13452973/
Some might have conducted similar studies prior to his.
Everything I write is lies, read between the lines.
Leave it to the Japanese to somehow work tentacles into the ailment!
:)
Liquid N2 can also break your heart. Shatter it actually
I'll let the people with mod-points take care of you. After that, please ask your parents to lock your pc. You are not ready for it yet.
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!
Perhaps you shouldn't make it 28? Life is too short to deal with someone who is terrible to you. It is a hard road to go down, but my life would have been hell without it and now I'm happier than I ever thought I could have been. Broken hearts heal.
> Try being married for 27 years to a serial adulteress
Can you please tell me where your house is located ? ;-))
Everything I write is lies, read between the lines.
I am a doctor.
The problem is recognizing that there actually is a problem. So many patients come in complaining of chest pain. However medicine is never about what the patient "says" is the problem (subjective data) but rather what we can objectively observe to be the problem. That's because medicine is about science, not speculation. The clinical history orients us to a range of possibilities (chest pain can be anything from muscular to pulmonary to digestive to cardiac/great vessel to neurological problems). We then ask further questions and perform tests to exclude/include certain conditions.
Because chest pain is so vague and also so common, we rely on EKGs and cardiac enzyme tests to confirm a diagnosis. Now there's a whole argument that the consequences of a heart attack are so severe that if there is doubt, we will treat it as a heart attack solely on strong clinical findings even when tests are inconclusive. However what usually happens is that the clinical history (heart disease in the family, patient age, blood pressure, cholesterol, diabetes, obesity, smoking, previous heart attacks) doesn't point to a heart attack, nor is the type of pain consistent with angina, and therefore the pain is "written off" as Treitze syndrome, either correctly or incorrectly. The patient is sent home. And usually NOTHING HAPPENS. It's very rare that patients are sent home to die of a heart attack.
However a study like this (provided it receives more supporting studies) opens up a few more possible diagnoses. However I would argue that the actual "mortality" (how many people die) or "morbidity" (how many people are permanently damaged) of this "broken heart" syndrome is very very low. So now do we treat anyone with chest pain as a heart attack "for the benefit of the doubt"? How much will this cost both the patient and the tax-payer in public health systems? Hell, if we're going to treat everyone, we don't even need doctors anymore, right?
No - medicine is still about evaluating a patient and the risks and benefits of treating versus telling them "take 2 tylenol and call back in the morning". As far as I am concerned this type of information changes nothing as there is no significant evidence that people actually die this way. While this so called "broken heart" syndrome can degenerate into dysrhythmias and/or plaque rupture and heart attacks, well, we already know about those.
Seven puppies were harmed during the making of this post.
EFT eh? Yes I find a strong, steady dose of Electronic Funds Transfer usually fixes a broken heart.
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
"You are so beautiful, if you don't talk to me I could die of stress-induced cardiomyopathy"
Every mans' island needs an ocean; choose your ocean carefully.
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.
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?
What's different is that this isn't an AMI at all. Myocardial infarction quite literally means death of the myocytes (heart muscle). In this cardiomyopathy, there is little if any dead muscle. There's a lot of stunned muscle. The difference is that if the muscle dies, there's nothing that can be done to make it move again. If it is stunned, it will move again on it's own, given enough time to recover.
The other thing is that the stress that causes Takotsubo cardiomyopathy causes a very different effect on the heart than the stress that causes an acute myocardial infarction. In AMI, the stress causes plaque rupture in one of the coronary arteries, leading to thrombus formation within the coronary artery and obstruction to the flow of blood. In Takotsubo, it's unclear what the stress actually did, but it certainly isn't causing a demonstrable plaque rupture. It's possible that it's causing transient spasm of the left main coronary artery, or possibly spasm of the entire capillary bed.
Also, Takotsubo cardiomyopathy has been known about for more than a decade. It just gets in the news every Valentine's day or so. :-)
Help! I'm a slashdot refugee.
you need some sort of commitment to be happy
That is not true. There are plenty of unmarried people out there. If they weren't happy they are free to marry. They don't. Therefore they are happy.
that commitment leaves you vulnerable
Very true.