Broken Heart Syndrome 

Definition

Broken heart syndrome is a temporary heart condition which is caused by tense situations, such as death of a loved one, which increase the release of stress hormones, such as adrenaline. The increased stress hormone levels cause a disruption of the normal pumping function of the heart. This results in the heart changing it's shape to resemble that of a Japanese octopus catching equipment called takotsubo.

This condition is therefore called takotsubo cardiomyopathy and usually resolves by itself within a week. The most affected demographic group seems to be women over 50 years of age.

Symptoms

The main symptoms of this condition include shortness of breath​ and chest pain. This can mimic the symptoms which are associated with a heart attack and patients are therefore initially managed for this.

The difference between takotsubo cardiomyopathy and a heart attack is the following. The coronary arteries in the former are not blocked but blood flow to the heart is reduced, whereas in a heart attack the blood flow to the heart is reduced due to blockage of the coronary arteries of the heart.

Causes 

Intense physical and emotional events can lead to this condition. Some possible triggers may include the following:

• News of a severe medical condition.
• Unexpected or sudden death of a loved one.
• Physical, sexual or emotional abuse.
• Massive financial loss.
• Loss of work.
• Divorce or other legal proceedings.
• Having to perform in a public situation.
• Physical stressors such as major surgery, being in a car accident, etc.

Certain medications can also be associated with broken heart syndrome, but this is a rare occurrence. These medications may include the following:

• Adrenaline, which is available in products needed to treat severe allergic reactions.
• Duloxetine or venlafaxine, which are anti-depressants.
• Levothyroxine, used to treat an underactive thyroid.

Complications

Although this is a self-limiting condition, it can be fatal. Since it can resolve quickly there doesn't seem to be many issues related to it, but there are a few important ones to take note of and they are as follows:

• Low blood pressure.
• Pulmonary oedema.
• Disruptions in the heartbeat such as arrhythmias.  

READ How to survive a heart attack when you are all alone?

Management 

There are no standard protocols for the treatment of this condition, but there are certain medications which can be used to help reduce the workload on the heart and they may include the following:

• ACE-inhibitors.
• Diuretics.
• Beta blockers.

Stress reduction is suggested to help prevent this condition or relapse of it. Certain techniques can be incorporated in order to do this and they may include the following:

• Breathing techniques.
• Massage therapy. 
• Yoga.
• Acupuncture.
• Meditation.

Consultation with a psychologist can also help to incorporate cognitive-behaviour therapy (CBT) in order to help replace negative thoughts with positive ones, and also help to use coping skills to deal with stressors and triggers.