How can I mend the br💔ken heart?
The idea of a broken heart may make you think about a bad breakup, a sad Hollywood movie or an emoji - it is in fact a real medical condition. Broken Heart Syndrome is also recognised as Takotsubo Syndrome (TTS), Takotsubo Cardiomyopathy (TCM) or Stressed Induces Cardiomyopathy (and several other names). It was described in Japan for the first time in 1990 by Dr Hikaru Sato, but the rest of the world did not recognise that condition until several years later.
What breaks your heart?
The causes of the TTS are still not fully understood. However, since Japanese researchers introduced this disease worldwide in the late 1990s, the topic has gained interest year by year, with hundreds of scientific research articles being published each year in the last almost three decades. It is believed that TTS is caused by an intense, physical or emotional stress, such as divorce, sudden illness, rejection, physical abuse, natural disasters (e.g. earthquakes), financial worry, grief or bereavement. Additionally, broken heart syndrome can be triggered by physical stressors such as severe pain, running a marathon, a car crash, an asthma attack, stroke, or surgery/treatment. Interestingly, this condition can also be triggered after a positive event, such as winning a lottery or even a surprise party! So perhaps double-check before you throw a party for your faint-hearted friend…
What does it have to do with the octopus trap?
Good question! Intense stressors, such as those mentioned above, can stun the heart, causing a huge release of stress hormones (e.g., catecholamines) that prevent the heart from contracting properly. Ballooning of the lower part of the left ventricle during contraction resembles Tako-tsubo – which is an earthen pot used by Japanese fishermen to trap octopuses. They deploy a string of interconnected pots into the ocean’s depths, which they retrieve after a few days. Octopuses “seek refuge in these pots to safeguard their delicate bodies from the challenging underwater conditions.”
How can I know if I have a broken heart?
Symptoms of the TTS can be similar to heart attack, such as sudden, intense chest pain and shortness of breath. Other most common symptoms are anxiety, sweating, nausea, vomiting, palpitations, and transient loss of consciousness.
According to British Heart Foundation, TTS may be diagnosed if tests rule out a heart attack and non-heart related problems. Another initial observation would be if your heart muscle looks weakened or isn’t pumping blood properly and your left ventricle has changed shape.
Additional test to confirm diagnosis can be requested, such as:
an electrocardiogram (ECG)
a blood test
an echocardiogram
a cardiac magnetic resonance imaging (MRI) scan
an angiogram.
With this particular medical condition, it is important to remember that diagnosis can be in the story of a patient and not in the lab test results. This is one of those conditions that data doesn’t always speaks by itself. Sometimes, it is not even obvious to the patient, what preceded the onset of the symptoms. Conversation with the patient is therefore an important key to diagnosing TTS.
Can it affect everyone?
Yes, it can occur in adults of any age. However, it occurs most commonly in post-menstrual women (>80% of cases) with lower estrogen levels. Estrogen is thought to be cardioprotective by mitigating the harmful effects of stress hormones.
The good news is that the heart muscle usually heals within 4 weeks, and most people fully recover within two months. It is possible that in some cases, people’s hearts will permanently change shape and result in persistent symptoms such as tiredness, chest pain and lack of energy. Reoccurrence of TTS is rare, with about 1 in 10 people may develop it again after they’ve recovered.
How can I mend the broken heart?
There isn’t a standard treatment for TTS (yet!), medicines such as diuretics, beta-blockers and blood-thinning medications might be prescribed when the condition is diagnosed, to reduce the stress on your heart and help your heart muscle recover.
How can I keep my heart in one piece?
There are no known ways that can prevent broken heart syndrome. However, taking the reins of your stress, learning problem-solving techniques can help you deal with physical and emotional stress. Additionally, relaxation techniques, such as practicing yoga or mindfulness, taking a walk or a warm bath or taking long, deep breaths and slowly exhaling, can also be very helpful.
Healthy habits can also help you not just to prevent TTS, but also lead a healthy lifestyle that your body will thank you for! These habits include:
Eating nutritious foods like those in the Mediterranean diet.
Getting regular exercise.
Getting seven to nine hours of sleep each night.
Spending time with others.
Keeping your medical appointments for check-ups and screenings.
Avoiding tobacco product use, recreational drug use and excessive alcohol use.
Broken hearts in the museum?
Experiencing a broken heart is a universal human experience that most of us have encountered at least once in our lives. With Valentine's Day fast approaching, it's natural to reflect on past relationships and the pain that can come with them. If you're struggling to find closure and move on, you may be interested in visiting the Museum of Broken Relationships.
Located in the Croatian capital of Zagreb, this museum is dedicated to showcasing items that represent the end of romantic relationships. While it may seem hard to believe that such a place exists, it is very much real and offers a unique perspective on the human experience of heartbreak.
Whether you've personally experienced broken heart syndrome or simply want to explore the complexities of love and loss, the Museum of Broken Relationships is a fascinating and thought-provoking destination that is well worth a visit.
Sources:
The National Center for Biotechnology Information PubMed (2024) “Takotsubo cardiomyopathy term search”, https://pubmed.ncbi.nlm.nih.gov/?term=takotsubo+cardiomyopathy&timeline=expanded&sort=pubdate&size=100, accessed 29th January 2024
St Vincent's Heart Health (2024) “Takotsubo Cardiomyopathy”, available at https://www.svhhearthealth.com.au/conditions/takotsubo-cardiomyopathy; accessed 29th January 2024
Ishant Khurana, et. al. SAHA Attenuates Takosubo-like Myocardial Injury by Targeting an Epigenetic Ac/Dc Axis. Signal Transduction and Targeted Therapy 6, 159 (2021). DOI: 10.1038/s41392-021-00546-y
British Heart Foundation (August 2024) “Takotsubo Cardiomyopathy”, https://www.bhf.org.uk/informationsupport/conditions/cardiomyopathy/takotsubo-cardiomyopathy#:~:text=Takotsubo%20cardiomyopathy%20causes%20your%20heart%27s,extreme%20emotional%20or%20physical%20stress. Accessed 29th January
The People’s Pharmacy, Show 1293: How Heartbreak Can Literally Lead to Broken Heart Syndrome; 14th March 2022; Spotify; Joe and Terry Graedon; https://open.spotify.com/episode/52wf5Bw2qp1XiBuC7x7yw8?si=145b979ee4d74359
Andre Dias et.al. Takotsubo syndrome: State-of-the-art review by an expert panel – Part 1, Cardiovascular Revascularization Medicine, Volume 20, Issue 1, 2019, Pages 70-79, ISSN 1553-8389, https://doi.org/10.1016/j.carrev.2018.11.015.
Broken Relationship Museum (2024) https://brokenships.com/ accessed 29th January 2024.