After Americans recently celebrated a COVID-19 version of Valentine’s Day, with its accompanying isolation, video dating, and physical distancing, it’s no wonder that the subject and the science of Broken Heart Syndrome is receiving renewed attention.
You might have found an occasional story about it in years past, but in 2021 the tone has shifted from a curiosity tale to a deadly serious topic.
“The only thing we really like about it is it usually goes away,” said Dr. Mark Haigney, professor and director of cardiology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. “With most people who come in with heart failure, you don’t get much improvement, even over time. Broken Heart Syndrome is one of the so-called reversible causes of heart failure. The heart can spontaneously recover its function. Unfortunately, that doesn’t always happen, and sometimes people die from it.”
From a military readiness perspective, love and matters of the heart may seem trivial. But heart healthiness is not just about solid nutrition and enough exercise. It also goes to the Total Force Fitness (TFF) domains of spiritual, social, and ideological fitness — that is, the beliefs and practices that strengthen one’s connectedness with sources of hope, meaning, purpose, and even love. The heart is not just a powerful red symbol of our inner selves. Our emotions connect directly to our entire health, head to heel.
Haigney remembers the first case of Broken Heart Syndrome that he ever saw, sometime in the late 1990s. It was a woman in her 40s getting a breast biopsy, when suddenly her blood pressure dropped, and the anesthesiologist had to give her a large dose of adrenaline. Her electrocardiogram (EKG) had changed drastically.
They stopped the procedure, took her to the intensive care unit where Haigney was working, and saw via ultrasound that her heart was not contracting in a normal way — it looked like she was having a major heart attack. But upon being rushed into a cardiac catheterization procedure, it was evident that her arteries were clear and normal.
“It was really mysterious because she had all the EKG changes suggesting a heart attack, and the pumping function of her heart was severely reduced, and yet the usual cause was not there. It got better over time and everything went back to normal, but it really had us perplexed,” Haigney recalled, citing a paper on the subject that came out years later from a cardiologist at Johns Hopkins Medicine in Baltimore.
“It described this transient, mechanical disorder in the heart that’s brought on by some kind of profound shock, or mental stress,” he said. “It’s a really interesting phenomenon, because if the person survives, they often go back to normal. They usually recover and do quite well. But to this day we don’t understand the exact mechanism, although it clearly involves the flight-or-fight response, the stress response by the nervous system that releases adrenaline into the circulation around the heart.”
Normally, he said, adrenaline causes the heart to contract in a more vigorous manner. But if there’s too much — perhaps brought on by overwhelming emotion — it can cause heart cells to die, and outright stun the heart. The condition, also called stress cardiomyopathy or Takotsubo cardiomyopathy, is usually brought on by grief, but can also be triggered by sudden overwhelmingly positive news. If you play the lottery, in other words, be forewarned: the chances are tiny, but you might win.