After a significant traumatic event such as a divorce or the death of a loved one, many individuals may experience distressing physical symptoms, including chest pain and shortness of breath.
This phenomenon is known colloquially as ‘broken heart syndrome’ but is officially referred to as takotsubo cardiomyopathy.
The condition is believed to be triggered by intense physical or emotional stress, which causes the release of stress hormones like adrenaline.
These hormones disrupt the heart’s ability to contract properly.
While most patients recover swiftly from broken heart syndrome, a minority may suffer severe complications, including heart failure.
A recent study published in the Journal of the American Heart Association presents alarming statistics regarding mortality rates associated with broken heart syndrome, particularly highlighting differences between genders.
Men are found to die from this condition at more than twice the rate of women, according to an analysis conducted on nearly 200,000 hospitalized adults in the U.S. between 2016 and 2020.
About 11% of men diagnosed with the syndrome died, contrasting sharply with around 5% of women.
These findings align with previous studies emphasizing that men not only experience broken heart syndrome less frequently but also tend to have worse outcomes when they do.
Dr. Harmony Reynolds, director of the Sarah Ross Soter Center for Women’s Cardiovascular Research at NYU Langone Health, noted, “It seems to be a consistent finding that men don’t get takotsubo syndrome as much, but when they do, they do worse.”
Cardiologists suggest that the differences in triggers for broken heart syndrome may shed light on this gender disparity.
For men, the condition is often precipitated by a physical stressor, such as surgery or a stroke, while women are more likely to experience emotional triggers, like the loss of a loved one or job-related stress.
Dr. Ilan Wittstein, a cardiologist at Johns Hopkins Medicine, pointed out that, “The people with emotional stressors actually do quite well.”
He theorizes, “Men may be more at risk for dying and having bad outcomes because they’re less susceptible to begin with.
So it takes a more dangerous trigger to precipitate the syndrome.”
Dr. Mohammad Movahed, the lead author of the study, added another layer to the analysis.
He suggests that men may struggle to recover from broken heart syndrome partly due to having less social support to help manage stress.
“If you have this stressful trigger, and the stress is not gone, that’s probably going to continue to harm the heart, or at least reduce the chance of recovery,” explained Movahed, a cardiologist at the University of Arizona’s Sarver Heart Center.
Despite the insights gained, the medical community still grapples with fundamental questions about takotsubo cardiomyopathy and its rare but serious outcomes.
Dr. Wittstein remarked, “People are still looking for the holy grail of what causes this condition.”
Determining the triggers for the syndrome remains complex.
While stress is a common factor, it may not be the sole trigger.
Physicians typically diagnose broken heart syndrome by identifying specific signs, including an enlarged part of the heart muscle resembling a balloon, and the absence of blocked arteries usually indicative of heart attacks.
Most patients are also able to identify a stressful event leading up to their condition.
Dr. Matthew Tomey, a cardiologist at Mount Sinai Fuster Heart Hospital in New York City, emphasized the emotional and physical burdens we bear in daily life.
He stated, “You can feel the heartache in those moments, and there may literally be some heartache of sorts that’s accompanying that.”
However, Wittstein cautioned that not everyone who experiences stress is at risk.
“Some people just get a little frustrated at work, or someone was out jogging a little too vigorously, or somebody just got stuck at a red light and was annoyed,” he noted.
This led him to propose that some patients may carry an inherent susceptibility to broken heart syndrome.
His research indicates that stress hormones can cause constriction of small blood vessels surrounding the heart, potentially diminishing blood flow and increasing risks for certain individuals, particularly those with existing conditions like high blood pressure or high cholesterol.
Additionally, emerging data suggest that post-menopausal women may be at heightened risk for broken heart syndrome, potentially due to declining estrogen levels that typically assist in blood vessel dilation.
Yet, Reynolds warned that more research is needed to definitively establish these connections.
She remarked, “It’s at some level obvious that sex hormones are implicated but trying to draw that link and really connect the dots, we have not gotten there yet.”
The uncertainties inherent to broken heart syndrome pose challenges for prevention and treatment strategies.
Cardiologists frequently prescribe medications that target other heart issues, like beta-blockers, and promote stress-reduction techniques such as mediation and mental health therapy.
Despite these interventions, Movahed stated, “We have not found anything so far — any medication, any specific treatment — that can reduce complications or reduce mortality.”
The study’s findings indicated that mortality rates remained relatively stable from 2016 to 2020, underscoring the insufficiency of current treatments.
However, Wittstein raised a pertinent point regarding the study’s reliance on diagnostic codes.
He noted that this sometimes leads to an incomplete understanding of the factors contributing to an individual’s death, particularly for those who may have suffered a stroke or other related health issues post-recovery.
His observations suggest that many patients might recover from broken heart syndrome only to face complications from other conditions.
Cardiologists uniformly agree on the importance of seeking immediate medical attention in the presence of chest pain or shortness of breath.
As Reynolds advised, “You can’t tell the difference between this and traditional heart attacks until you get to the hospital and have a series of tests.
So it is not appropriate to stay home when you have chest pain.”
image source from：https://www.nbcnews.com/health/heart-health/men-are-likely-die-broken-heart-syndrome-study-says-rcna206276
