Broken Heart Disease: How heightened stress-levels can weaken heart muscles

In the modern, fast-paced world, feeling stressed has now become a common phenomenon. Many people throughout their lives have felt acute or short-term

stress

that is temporary in nature, triggered as a reaction to minute discomforts like stage fear, hitting sudden brakes to prevent collision, and more. Chronic stress, however, is constantly feeling overwhelmed and pressurized. This may lead to conditions like

broken heart disease

.

Broken Heart Disease, also known as Takotsubo cardiomyopathy or

stress-induced cardiomyopathy

, can be defined as a condition in which extreme emotional or physical stress weakens the heart muscle temporarily. It is usually mistaken for a heart attack, primarily affecting the left ventricle and causing it to balloon or lose its normal contraction pattern.
When the body is exposed to excessive levels of stress hormones, such as adrenaline and cortisol, the condition leads to its increased production in response to such conditions. Since the hormones serve as part of the “fight-or-flight” system, their activity sometimes harms the heart. It either causes spasms of the coronary arteries or negatively impacts the proper pumping of blood. Other consequences include altering temporarily the blood supply, enhancing the inflammatory processes, and interfering with the electrical conductivity necessary for cardiac muscle, mediated by vital electrolytes.

How does broken heart disease occur?

According to Dr. Brajesh Kumar Mishra, Interventional Cardiologist and Cardiac Electrophysiologist, Manipal Hospital Gurugram, “When an individual experiences a stressful event, the body produces hormones such as adrenaline and non-adrenaline that make an effort to help the body cope with stress. The heart muscles may become overwhelmed with the excessive amounts of adrenaline that is caused by the high levels of adrenaline in the body. This can further lead to the narrowing of the arteries that supply the heart with blood, which induces a temporary shortage of blood flow to the heart. The effect of adrenaline on the heart during

broken heart

syndrome is, in most cases, temporary and reversible. The heart recovers within days or weeks.”

Symptoms of broken heart disease

According to Dr. Amit Kumar, Associate Director & Head (Unit I) – Interventional Cardiology, Sarvodaya Hospital, Sector-8, Faridabad, “The symptoms of broken heart disease are sudden chest pain, shortness of breath, and irregular heartbeat, often initiated by an event such as grief, shock, or even acute physical stress. Unlike a heart attack caused by the blockage of arteries, Takotsubo cardiomyopathy does not cause permanent damage to the heart tissue and is usually reversible with proper treatment.”

Who is more at risk of broken heart disease?

This is more common in middle-aged and older women, likely due to hormonal differences, including decreased levels of estrogen. Most patients recover fully within weeks, but some suffer complications in the form of heart failure or arrhythmias. Good management is achieved through stress reduction, beta-blockers, and the treatment of underlying triggers; hence, there is a strong emphasis on the important relationship between emotional health and cardiac function.

Is it life-threatening?

The broken heart syndrome, in some cases, can be life-threatening. There is an extremely minute chance of a broken heart syndrome causing death. In rare cases, it may cause:
weakness of the heart muscles.
Irregular heartbeat
Chest pain
Shortness of breath
Dizziness or fainting

How does the broken heart syndrome differ from a heart attack?

While the symptoms of stress, cardiomyopathy, and heart attack mimic each other, the causes don’t match.
1. No underlying heart disease: A heart attack is caused by reasons like blocked arteries, while broken heart syndrome is caused by a traumatic event. The person suffering from broken heart syndrome may have an underlying disease.
2. Better recovery rates: The recovery and survival rates are fairly high in the case of broken heart syndrome. Recovery from heart attacks is a time-consuming process. People who have had a heart attack may have higher chances of reoccurrence or even develop other heart conditions.
3. Temporary condition: Broken Heart Syndrome is a temporary condition, while a heart attack does have long-term implications.

Good practices to reduce stress on the heart

Exercise routinely: Exercise can help to counteract the effect of stress. Having thirty-minute exercise sessions for 5 days weekly can improve overall cardiac health, control weight, maintain blood pressure levels, and contribute to holistic health. Regular exercise can reduce the risk of depression as well.
Managing work stress: When one suffers from long-term anxiety, work stress can become an issue. One can practice hobbies to relax and lift one’s mood. Regular breaks from work are also advised.
Seeking professional help: Dealing with stress and understanding its root cause is an ideal way to start. The doctor can also suggest methods for theory and cardiac rehabilitation.

Treatment of broken heart disease

The goal of treatment is supportive care to sustain life and minimize complications until full recovery, which usually occurs within a few weeks. In mild cases, either no treatment or a short course of limited pharmacological therapy may be sufficient. In severe cases complicated by progressive circulatory failure, some patients need to be considered for mechanical circulatory support as a bridge to recovery. However, B blockers, calcium channel blockers, ACE inhibitors, diuretics, and aspirin may be required to treat heart failure.