Broken heart syndrome

For decades, medicine has recognised the powerful way grief can influence the heart. It’s been called Broken heart syndrome or Takotsubo cardiomyopathy and evidence that severely stressful life events increase the risk of acute cardiovascular incidence, like a heart attack, continues to grow. Meanwhile, anecdotal reports and case studies have long described the relationship between acute stress and the development of an irregular heartbeat, known as cardiac arrhythmia the most common form of which is atrial fibrillation. The mechanism could be hormonal processes, such as adrenalin and catecholemine surges, which can disrupt heart rhythm if the release is excessive and prolonged.

The Japanese term ‘Tako tsubo’ means ‘octopus pot’, which is a fishing jar with a narrow neck and wide base used to trap octopus. Its shape is not unlike the shape of the heart’s left ventricle when it suffers from the ballooning effect associated with the syndrome.  Broken heart syndrome was first described in medical literature in Japan; the description dates to 1990.

"Heart-break" is impermissible as a medical cause of death, and on death certificates the most common entries are heart disease and cancer. The death rate from heart complaints of a sample of British widowers was 67% above expectation. A USA study linked 71% of a sample of women with cancerous cervical smears had feelings of loss and hopelessness.

Being 'broken-hearted' as a result of emotional trauma may be a more apposite turn of phrase than we imagined. US researchers have shown how sudden emotional stress can release hormones that stun the heart into submission, resulting in symptoms that mimic a typical heart attack. People suffering from stress cardiomyopathy (takotsubo cardiomyopathy in Japan), or 'broken-heart syndrome', seem to be having a heart attack: they have chest pain, fluid in the lungs, shortness of breath and heart failure. But although the ability of the heart to pump is significantly reduced and the heart muscle is weakened, it is not killed, or infarcted, as in a classic attack. The syndrome is linked with elevated levels of hormones called catecholamines (particularly adrenaline).

A study conducted at Aarhus University and published in the journal Open Heart in 2016, was based on data from nearly one million patients. It has shown a significant link between loss of a partner and development of atrial fibrillation. The risk of developing an irregular heartbeat for the first time was 41% higher among those grieving a partner’s loss compared to those who hadn’t experienced such loss. The condition could persist for up to a year after the tragic event. The risk was higher in those under 60 years olds and the effect was most dramatic in those who had unexpectedly lost a healthy partner. The heightened risk was apparent irrespective of gender and other underlying health conditions.A