Volume 23

It Doesn’t Only Happen In The Movies

You’d watch this movie scene play out with disbelief, a little disappointment and a silent eye roll, as you were really hoping for a better executed and more thoughtful ending for the character.

Well, as it turns out, it is POSSIBLE (although extremely rare) that a person might die from a broken heart. Our minds and bodies are intricately connected and that isn’t just a New Age type of thing to say. Mental and emotional states can profoundly affect our health or lack thereof, as the case may be.

We’ve all read or heard stories about an elderly person who passes away, and her death is soon  followed by the passing of a longtime spouse. Onlookers might even say, “Oh, he died of a broken heart.”

Takosubo What?

It is quite possible for our emotions to affect our heart, to the point where a person could die as a consequence, if the symptoms and signs are not recognized or dealt with promptly. This condition is referred to as Takotsubo cardiomyopathy or “TCM”.

TCM occurs when the left ventricle balloons out and does not contract effectively, so the heart does not pump efficiently. Takotsubo comes from the Japanese words tako (octopus) and tsubo (trap), because that is what the left ventricle looks like when it balloons out. It is usually triggered by an intense emotional stressor and mimics a heart attack in how it presents.

Heart Attack Compared 

Just to briefly go over, the symptoms of a heart attack are crushing chest pain (that may extend to the left upper limb), associated with shortness of breath, palpitations, profuse  sweating and sometimes a jaw or toothache. Those are the classical symptoms.

However, women sometimes present with symptoms that are more vague and different from men. They may not have overt chest pain, but, rather, a vague discomfort. Reflux symptoms can also be a symptom of an impending heart attack. If a person is experiencing any of these symptoms, they should go and see her doctor as soon as she can. This applies even more so if they are in a higher risk group. Level of risk increases if they have a family history of cardiovascular disease, have other co-morbidities (especially chronic illnesses such as diabetes and hypertension), are smokers, are obese and other factors such as gender and age (heart attacks are more common among men and in an older demographic).

What Happens

Back to TCM, often times, the sufferers are post-menopausal women, although it has been reported to occur in children and young adults. It is a completely reversible condition, with proper management. However, there are instances when the condition may escalate and go on to cardiogenic shock and ultimately, death. This usually occurs in younger patients, where they may also be a physical precipitant. The difference between TCM and an actual heart attack, however, is that, in TCM, there are no actual blockages in the heart vessels.

ECG (electrocardiogram) changes are generally non-specific in TCM and cardiac enzymes (that are assessed in all patient’s who present with symptoms of suspected Acute Coronary Syndrome), are only slightly elevated. The enzymes decrease rapidly upon subsequent testing.

“No Man Is An Island”

The management of TCM is mainly supportive. Symptoms are managed via the administration of beta-blockers, a type of drug that lowers the heart rate and allows it to pump effectively. Other medications for heart failure may also be administered, if indicated. Anxiolytic medication is also prescribed, in order to address the emotional state that triggered the symptoms in the first place. With proper care, the patient will completely recover within a few days.

Pre-emptively, it would make sense for a person to either seek out or have other people approach to support them during periods of emotional duress.

The phrase, “No man is an island” could not be truer, especially in times of turmoil. Check on your friends and loved ones, when they are going through challenging times. Periods of intense stress can be such as the death of a close family member, divorce or if they have been made redundant at work. Some people may not express their need for help or they may put on a stoic face, as they still have to deal with everyday life.

Being a source of support could be as simple as making a phone call or sitting with them through their grief/anger/stress and offering a non-judgemental, listening ear. It could also be via acts of service, such as offering to watch their kids (while they sort out what they need to do) or even inviting them over for a meal.

So, next time you come across that cheesy scene in a movie, think about TCM and how it is actually based in reality.

* If you are experiencing symptoms that are alarming and indicative of a heart attack, do NOT self-diagnose yourself with TCM. Seek medical attention immediately

Dr. Reshma Stanislaus is a medical doctor (general practitioner) and an alumni of AIMST University. She also holds degrees in Psychology and English from the University of Manitoba. Her interests are preventive and functional medicine, nutrition i.e. the role of diet in disease prevention/cure, psychology and parenting-related topics. In her free time, she enjoys writing poetry and outdoor activities with her family. She’s the mother of Nikhil, Mishka and Ishaan. Touch base with her at mogoat@yahoo.com