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"Broken
Heart" Syndrome
by Elizabeth Bussey Sowdal
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The
first week of February the folks at the famous Johns Hopkins University School
of Medicine announced their findings on stress induced cardiomyopathy, which they
have dubbed "Broken Heart" Syndrome. This is a condition found most frequently
in middle aged and older female patients who have suffered sudden emotional stress.
The researchers (lead by cardiologist Ilan Wittstein, M.D.) list as common precipitating
stressors such things as hearing news of a death, suffering an accident, and armed
robbery. Also listed as culprit stressors are such things as (now prepare to be
a bit surprised) fear of public speaking, a court appearance or even the shock
from a surprise party!
The inclusion of a surprise party as one of the
common stressors really surprised me. Imagine that! "Surprise! Oops." But I can
see easily how it might happen. I was bringing groceries in from the car the other
day, my hands were full, the cat was trying valiantly and with feline determination
to trip me, I was juggling my purse and bags and keys and trying to open the door
when I caught a little movement out of the corner of my eye. I thought I might
have bumped the cat with the storm door which I was trying to keep open with my
talented left hip and I glanced back to see. I turned a little to look and came
face to face with a great big grin, a shock of curly hair and two mischievous
eyes. AAAA! I don’t know where it all went, but for just a second I felt that
I was completely empty of blood and air and bones. I felt like I was just a wispy,
empty husk waiting for a strong breeze.
"Silent like a Ninja," Davey chortled,
for that was who it was. My Dave, the child I have cherished and fed all these
years. Funny, funny boy that one! I staggered into the house, dropped my bags
in the floor and collapsed into a chair. "Don’t ever," I gasped, "ever do that
to me again!" He crowed, he cackled, he bounced on the balls of his Ninja feet
and if my muscles had not been, at that moment, the approximate consistency of
warm custard, I might have thrown something at his grinning Ninja head.
What might have been happening to me inside, according to Johns Hopkins researchers,
was that the sudden shock had caused my body to release floods of catecholamines
such as adrenalin and noradrenalin into my blood stream. I am no stranger to the
occasional wash of adrenalin through my system, living as I do in a house full
of comedians and with a relatively high stress lifestyle, and maybe this was to
my advantage. Researchers have found that some people are not so lucky and that
the breakdown products of the catecholamines, such as metanephrine and normetanephrine,
can stun cardiac muscles effectively enough to cause chest pain, shortness of
breath and heart failure. All, you will note, symptoms of myocardial infarction,
what we commonly call a heart attack.
Despite presenting with symptoms
similar to those of a heart attack, patients with stress induced cardiomyopathy
had clinical findings much different than those of a heart attack patient. For
the most part the patients were previously healthy, had few risk factors, angiograms
showed no blockages in the arteries supplying the heart and cardiac enzymes in
the blood were not elevated. ECGs, or tracings of the heart's rythmn, showed normal
left ventricle function (at the bottom of the heart), but compromised atrial function
(at the top and middle of the heart). Catecholamine metabolites were two to three
times higher than those found in patients with a heart attack, and were seven
to thirty-four times higher than normal levels. Additionally, MRI scans showed
no irreversible muscle damage to the heart and recovery rates were much faster
than in a typical heart attack. In most of these patients there was great improvement
in heart function within a few days and recovery within two weeks.
This
new research on "Broken Heart" Syndrome brings medicine one step closer to the
wisdom of "old wives" over the centuries. How many times when you were growing
up did you hear your Grandma or Aunts tell about somebody who had a shock that
nearly killed her? I am eagerly looking forward to reading a future article explaining
in scientific terms that some people suffering a shock really do go white-headed
overnight. I may need to sign up as a test subject for that study if these boys
of mine keep it up. (www.hopkinsmedicine.org) | |
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