What is broken heart syndrome and what are the symptoms?

This February 14 is celebrated on lovers day. A few hours before the start of this “romantic” day, the Argentinian Society of Cardiology (SAC) and the Argentinian Cardiology Foundation (FCA) warn that a heart can be broken and that the expression “broke my heart” has an organic origin. ” It’s not a legend ; can happen and it is important to know what it is so that you can consult in time or help those with these symptoms,” they said.

Dr. Carolina Salvatori (MN 97.522), cardiologist and advisor to the Clinical Cardiology Council of the Argentine Society of Cardiology, told as an example one of the episodes she detected during a medical consultation, in which she warned that this feeling had become a pathology which was highlighted thanks to an electrocardiogram.

“Blanca, 55, came to my office after 2 years of great distress because after a year of caring for her sick husband (who died 3 months ago), despite being unwell, paperwork and fatigue delayed her consultation. When I do the electrocardiogram, I am surprised to find a new scar on his heart (a heart attack). I begin to ask about the symptoms: Blanca tells me that two days before her husband’s death, and during hospitalization, she felt very strong pain in her chest with a great feeling of anguish, thinking and justifying his illness as a result of the stressful situation,” says the expert.

As they pointed out, “this is one of the cases that comes up in the doctor’s surgery or at a caretaker’s, where after a situation of physical stress (an operation, intervention) or psychological stress (separation, bereavement, dismissal, natural disasters or the death of pets, among others); that is, after extreme emotions, You may develop a heart attack.

“Although the most common cause of myocardial infarction is atherosclerosis, the product of (modifiable) cardiovascular risk factors such as high blood pressure, dyslipidemia, smoking, diabetes, obesity, psychosocial, among others, or (not editable) such as background or age, there is the so-called “Takotsubo Syndrome” (also known as broken heart syndrome) or stress cardiomyopathy, which was described in the 1990s in Japan,” Salvatori said.

According to experts, this pathology takes its name “from a bulging-shaped vessel with a narrow neck used by fishermen in this country to catch octopus, since this is the shape that the heart acquires after undergoing this type of injury, where the apex of the heart stops and is reached.” They also indicated that in the 85% reported cases are postmenopausal women who, after experiencing an unexpected stressful situation (physical or emotional), exhibit an excessive release of adrenaline.

It is syndrome It is characterized by a presentation similar to that of a myocardial infarction, with symptoms such as chest pain, shortness of breath, abnormal electrocardiogram, elevated heart enzymes and reduced blood supply to the heart, which in this case is not due to an occlusion. from the heart an artery by a blood clot as in atherosclerotic disease.

“In Takotsubo syndrome, the arteries of the heart are almost always normal (confirmed by catheterization, a study that shows the inside of the arteries), but the part of the heart affected by the decreased blood flow (usually the apex of the heart) usually contracts less strongly initially. In most cases, this weakness recovers after a few weeks and the heart contracts normally again,” the experts said in a statement.

It is for this reason that the SAC and the FAC have stressed the importance of “keeping in mind that when faced with a situation that our mind considers threatening, the adrenaline is immediately released to prepare us both to face this situation (combat) and to dodge or move away (flee).

There adrenaline It has effects on both the heart (causes tachycardia, which is the increase in heartbeat) and closure on the blood vessels (vasoconstriction), producing, by both mechanisms, a very significant decrease or directly the stoppage of blood flow that supplies the heart heart muscle

In this sense, Dr. Julio C. Giorgini (MN 100.308), cardiologist, member of the Board of Psychosocial Aspects and of the Heart and Woman Area of ​​the Argentine Cardiological Foundation (FCA), explained: “In other cases where the situation exceeds it, we can even remain “paralyzed” or lose consciousness (syncope), as part of an ancient mechanism for coping with stressful situations”.

According to a study published by the American Heart Association (AHA), there is a higher incidence of this syndrome in middle-aged and older women, at a rate 10 times higher than in men or younger women. “This study showed the fundamental role of the connection between the brain and the heart,” Salvatori said.

Likewise, from the Argentine Society of Cardiology and the Argentine Cardiology Foundation, they claimed that it is possible to quantify cholesterol levels, blood pressure and blood sugar, but it is difficult to quantify how much a person is stressed, depressed or sad. “Without a doubt, the heart and the emotions are linked and achieving good stress management is as important as dealing with the “classic” factors such as hypertension, smoking, high blood sugar or cholesterol, or being overweight. “, he indicates.

Experts even pointed out another important fact: after the age of 50, the incidence of cardiovascular diseases in women gradually increases with age and even exceeds that of men. This happens because you lose the protection that female hormones generate on the cardiovascular system, because substitution therapies after menopause have not shown cardiovascular protection.

“Although the popular belief is that the leading cause of death in women is cancer of gynecological origin, this is not the case,” Salvatori said. While Giorgini added: “Cardiovascular disease is the leading cause of death among women, affecting 1 in 3 womenversus mortality from gynecological tumors which occurs in 18% of cases”.

“It’s no small feat, since women have their annual gynecological check-ups, but they don’t usually check their hearts. Often, even the symptoms of a heart attack are confused and minimized into thinking it’s just stress,” experts point out.

On this point, the cardiology societies reported that a recent 2021 AHA review assessed the impact on cardiovascular disease of conditions such as anxiety, unpleasant emotions like anger, anger, sadness, illnesses like depression or even being pessimistic. After their analysis, it was shown that, together, increase close to a 30% the risk of having heart attack.

“Anger or temper tantrums increase the risk of a heart attack, stroke or malignant cardiac arrhythmia by up to 20% and most of these episodes occur within 2 hours of the anger or temper tantrum Major depression occurs in 5-7% of the general population, but reaches up to 15% in people who have had a heart attack,” the experts point out.

On the other hand, according to Giorgini, “taken also as a whole, beneficial attitudes, such as having a positive outlook on life, optimism, meditation and mindfulness diminish a 18% the risk of suffering a coronary event.

With Valentine’s Day just hours before they begin their “romantic day”, experts have highlighted the importance of the relationship between the physical contact and the heart.

“There are studies that have shown that caresses and hugs generate a safe environment, greater neural connection between two people and greater activation of the ventral part of the vagus nerve, strengthening bonds and secure attachment (both in children than in adults).At the cardiovascular level, activation of the ventral vagus nerve (located in the stomach) stimulates parasympathetic action, increasing cardiac variability and coherence and decreasing heart rate (fewer arrhythmias and tachycardia) and blood pressure (less hypertension). In conclusion, caresses and hugs are good for the heart!” concluded Giorgini.

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