What becomes of the broken-hearted? Stress and the Human Heart
March 30, 2022
The Irish playwright, Oscar Wilde, observed that the heart was made to be broken. Being human ensures that each of us will experience at least one heartbreak in our lives – this heartbreak could even add to the richness of our humanity or sow the seeds for future happiness. In fact, the medical community has long questioned whether heartbreak or its’ frequent companion, severe or chronic physical or emotional stress, can damage the human heart, the muscle responsible for each life sustaining breath.
For millennia, doctors have treated patients with physical ailments suspected to be associated with strong emotion or psychological causes. Such ailments might include headaches, stomach pain or just a general feeling of sickness. But what about the heart? Decades ago, astute Japanese researchers began to note a pattern of a weakened heart muscle, occurring most often in post-menopausal women who have recently undergone physical or emotional stress (1). Described in 1990 as stress cardiomyopathy and dubbed “Takotsubo Syndrome”, the Japanese name for a plant that resembles the affected heart, this condition often presents with chest pain and possible ECG and blood test changes seen with a heart attack. This can definitely present a diagnostic challenge as a patient is wheeled into surgery to undergo a coronary angiogram and an unblocking of diseased arteries, only to find there are no significant blockages at all. In those cases, further investigation will reveal the main pumping chamber of the heart to be weakened, hence the term cardiomyopathy (disease of the heart muscle).
As stated, mostly older women are affected; one study reported nearly 90% female with an average age of nearly 67. Interestingly, and in keeping with the stress component of the cardiomyopathy, higher rates of neurologic or psychiatric disorders (55.8%) were reported in the group with this condition versus the 25.7% presenting with true heart attacks (2).
The good news? Stress cardiomyopathy is often treatable with common heart medications and has excellent prospects for a full recovery, perhaps in excess of 90% (2). And although the mind-body connection continues to challenge medical professionals, it does provide a certain amount of insight into overall health and the ability to diagnose and treat certain ailments.
1) Kazuo Komamura et al., Takotsubo Cardiomyopathy: Pathophysiology, diagnosis and treatment. World Journal of Cardiology. July 26, 2014.
2) Christian Templin et al., Clinical Features ad Outcomes of Takotsubo (Stress) Cardiomyopathy. The New England Journal of Medicine. September 3, 2015.