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The Impact of Strong Emotional Experiences: Understanding Takotsubo Cardiomyopathy

Strong emotional experiences are a trigger for this diseaseIlya Barkhatov / 74.RU

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Death from unrequited love or the loss of a loved one has long become a literary cliche. Emotionally, such experiences often feel like a crushing pain in the chest. It turns out that this expression is used not only by writers. In medicine, there is the concept of “broken heart syndrome,” also known as Takotsubo cardiomyopathy. Scientists have proven that the body’s reaction, for example to the loss of a loved one or even to unexpected happiness, is completely physiological in nature. Is it possible to truly die from sadness or joy?

Takotsubo cardiomyopathy was first described by Dr. Hikaru Sato from Hiroshima City Hospital. He gave this name to the disease because in patients with this syndrome, the left ventricle (the main pumping chamber of the heart) has an abnormal shape – narrow at the top and widening at the bottom. The doctor remembered that it reminded him of the octopus pot used in Japan.

Takotsubo cardiomyopathy is a type of non-ischemic cardiomyopathy in which a sudden, transient decrease in myocardial (heart muscle) contractility develops. Because myocardial weakness can be caused by emotional stress, such as the death of a loved one, the condition is also called “broken heart syndrome.”

Cardiologists believe that not only grief, but also happiness can “break” a person’s heart. This is confirmed by research published in the European Heart Journal.

Doctors spent 4 years examining 1,750 patients from all over the world with takotsubo cardiomyopathy, a disorder of the heart muscle that often leads to acute heart failure. The researchers found that in 485 people, CT was triggered by a strong emotional experience. Moreover, for 20, the “reason” was positive events – for example, a wedding and the birth of grandchildren.

This is what pots for catching octopuses (“tako tsubo”) look like in Japan, after which the syndrome 松岡明芳 is named.松岡明芳 / Public domain / Wikimedia.org

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Scientists provedthat the brain is involved in the development of “broken or happy heart syndrome.” They found that areas of the brain responsible for processing emotions and controlling unconscious body functions such as heartbeat, breathing and digestion communicate less well with each other in patients with Takotsubo cardiomyopathy than in healthy people.

People with diseases in which there is an excess of “stress hormones” are at risk. With any experience, the level of these hormones increases. At this moment they affect the body and especially the heart. It must be said that this is a standard reaction of the body under stress, but in some cases it turns out to be fatal. Bad news, the loss of a loved one, a minor accident, or even speaking in front of a large number of people can kill such a person. The number of patients with this syndrome has predictably increased during the COVID-19 pandemic.

“Stress can take a physical toll on our bodies and hearts, as evidenced by the rising number of cases of stress cardiomyopathy we are experiencing,” Ankur Kalra, MD, a cardiologist at the Cleveland Clinic, told JAMA Network Open at the height of the pandemic.

The disease most often affects older and middle-aged women – they are diagnosed with “broken heart syndrome” up to 10 times more often than young women or men of any age.

Most cases of “broken heart syndrome” occur during the spring and summer months. But heart attacks have a different seasonality – they mainly occur in winter and autumn. Therefore, scientists concluded that the syndrome, contrary to popular belief, is neither a precursor nor a form of heart attack and is associated not with blockage of the arteries, but with dysfunction of the heart muscle.

Fortunately, deaths from “broken heart syndrome” are still very rare. It is estimated that it affects less than 3% of people who have a heart attack and typically occurs between the ages of 60 and 75. So don’t be afraid to be emotionally happy or sad with all your might. Most likely, it will not harm you, but quite the opposite.

Behind a broken heart lies a medical condition that causes conditions that are similar to, but are not, a heart attack. But their symptoms are similar – the heart beats poorly, patients have shortness of breath and chest pain.

Unusual fatigue

From a report published in the journal Circulation, it follows that 48% of women surveyed suffered from sleep disturbances in the month before a heart attack. Another common complaint among these women was unusual fatigue—71% of those surveyed suffered from it.

A report published in Heart and Lung: The Journal of Cardiopulmonary and Acute Care discussed some potential causes of the observed sleep disturbances. Thus, they were closely associated with anxiety, fatigue and pain, as well as changes in thinking and memory. Taken together, these symptoms may be an important warning sign of an impending heart attack, the researchers note.

Moreover, it is well known that women and men with poor cardiovascular health regularly suffer from short sleep, too much sleep and other distortions.

It is very important to monitor yourself, because, according to WHO estimates, 80% of premature heart attacks and strokes can be prevented.

We automatically consider chest pain on the left to be pain in the heart, and at the same time a symptom of a heart attack. But in fact, it can also be muscle pain; stomach problems also sometimes manifest themselves this way.

“Many people have ever experienced pain in the heart area, but it is not always associated with the heart,” says cardiologist Maria Yakovleva.

Maria Yakovleva – functional diagnostics doctor, cardiologist, Consultative and Diagnostic Center in Kupchino (division of the N. N. Petrov National Medical Research Center of Oncology).

The most common cause of chest pain is coronary heart disease – a heart disease that occurs when there is poor blood supply to the heart muscle, resulting in damage to the myocardium. This is a widespread cardiovascular pathology, often leading to death. Types of cardiac ischemia:

angina pectoris; myocardial infarction; post-infarction cardiosclerosis; heart failure; sudden arrhythmic death.

Ischemic heart pain has a number of specific signs, the expert notes. Your heart really hurts if:

the pain is of a certain nature – pressing, burning; the pain is localized behind the sternum. They can radiate to the left arm, left shoulder, or lower jaw. Less often – in the right shoulder, right arm;
pain may be felt in the upper abdomen, sometimes accompanied by vomiting. This is a sign, in particular, of diseases of the cardiovascular system, namely, infarction of the lower wall of the left ventricle;
pain occurs after physical or emotional stress;
the duration of pain is relatively short – from several minutes to several hours;
This pain goes away with rest or after taking certain drugs that dilate the blood vessels of the heart, such as nitroglycerin.

“If all these criteria come together into one “bouquet,” then this is typical pain in the heart of an ischemic nature,” says cardiologist Maria Yakovleva. – At the same time, there is no difference who experiences such pain – a man or a woman, there are no gender differences in the nature of the pain.

Strong emotional experiences are a trigger for this diseaseIlya Barkhatov / 74.RU

This is what pots for catching octopuses (“tako tsubo”) look like in Japan, after which the syndrome 松岡明芳 is named.松岡明芳 / Public domain / Wikimedia.org

2023-10-07 05:15:15

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