rapidly weaken the heart muscle.
Ilan Wittstein, M.D., the program director of the Johns Hopkins Advanced Heart Failure Fellowship, answers some common questions about broken heart syndrome and how it can be treated.
What is broken heart syndrome?
Broken heart syndrome is a condition that can cause rapid and reversive heart muscle weakness, also known as stress cardiomyopathy.
What causes broken heart syndrome?
Two kinds of stress — emotional or physical — often cause broken heart syndrome. But while most people with this condition experience a stressful event, up to 30% of patients have no identifiable trigger at the time of their initial symptoms.
Emotional Stressors
Emotional stressors include:
- Grief
- Fear
- Extreme anger
- Surprise
Physical Stressors
These conditions include:
- High fever
- Strooke
- Seizure
- Difficulty breathing (such as an asthma attack or emphysema)
- Significant bleeding
- Low blood sugar
What are the symptoms of broken heart syndrome?
The symptoms of broken heart syndrome can mimic symptoms of a heart attack, including:
- Chest pain
- Shortness of breath
- Diaphoresis (sweating)
- Dizziness
These symptoms may begin as soon as minutes or as long as hours after an emotionally or physically stressful event.
How does sudden stress lead to heart muscle weakness?
When you experience a stressful event, your body produces hormones and proteins such as adrenaline and noradrenaline that are meant to help cope with the stress.
The heart muscle can be overwhelmed by a massive amount of adrenaline that is suddenly produced in response to stress. Excess adrenaline can cause narrowing of the small arteries that supply the heart with blood, causing a temporary decrease in blood flow to the heart.
Alternatively, the adrenaline may bind to the heart cells directly, causing large amounts of calcium to enter the cells. This large intake of calcium can prevent the heart cells from beating properly. It appears that adrenaline’s effects on the heart during broken heart syndrome are temporary and completely reversible — the heart typically recovers fully within days or weeks.
