Healing a Broken Heart

Broken Heart Syndrome (BHS) or stress-induced cardiomyopathy is a rare form of heart disease, recently found to be associated with genes. In a study published in the Journal of Neurosurgery, researchers have identified the suspect genes by next generation DNA sequencing which were exhibited in seven women who suffered from broken heart syndrome.

The gene variants identified in the study were MYLK2, DSG2, FKTN and LDB3, which were previously known to play a role in other cardiac diseases. It is more common in women, especially in post-menopausal stages, and is also found more in Asians and Caucasians, but less common in children and young adults.

Dr T.N.C. Padmanabhan

What is BHS?
Broken Heart Syndrome is a temporary heart condition that’s often brought on by stressful situations, such as the death of a loved one. People with Broken Heart Syndrome may have sudden chest pain as in a heart attack, but there’s a temporary disruption of your heart’s normal pumping function, while the rest of the heart functions are normal or with even more forceful contractions.

Broken Heart Syndrome may be caused by the heart’s reaction to a surge of stress hormones. The symptoms of Broken Heart Syndrome are treatable, and the condition usually reverses itself in about a week.

Reasons unknown
The exact cause of BHS is unclear. It occurs during periods of extreme emotional outburst, psychological or interpersonal conflict or excessive physical stress.

Dr A. Sreenivas Kumar, chairman, cardiovascular sciences and chief cardiologist at Citizens Hospitals, explains, “At times of stress, stress hormones called catecholamines are released. In some people, there is excess release of hormones, which results in damage to the heart muscles. There is a sudden decrease in the heart function resulting in heart failure. As the receptors for the hormones are located near the heart’s apex, more damage occurs there, resulting in increase in the size of the apex, called apical ballooning. It looks like a Japanese net to catch octopus fish (tako tsubo), which is why it’s also called takosubo cardiomyopathy.”

Nearly 20 per cent of patients may develop severe complications like heart failure, severe fall in blood pressure called cardiogenic shock, leakages in valves, rhythm disturbances and, sometimes, rupture of the heart. Death may also occur in three per cent of the patients.

Not heart attack
The Broken Heart Syndrome is different from a heart attack. In heart attack, there is complete blockage of heart artery due to blood clotting at the site and narrowing of the arteries due to fat build up. But here, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.

Dr Anuj Kapadia, senior interventional cardiologist at Care Hospitals, says, “Once identified as BHS, doctors prescribe heart medications, beta blockers or diuretics to reduce the workload on the heart and help to prevent further attacks. Some patients take a month or two to recover completely. There’s a small chance that it can recur after the first episode. There’s no proven therapy to prevent additional episodes; however, doctors recommend long-term treatment with beta blockers or similar medication that block potentially damaging effects of stress hormones.”

Major role by stress
In the present times, due to extreme physical and mental stress, BHS can also occur when one is healthy, claim doctors. Dr T.N.C. Padmanabhan, consultant interventional cardiologist at Krishna Institute of Medical Sciences, says, “Studies have shown that lots of patients of this ailment have had depression and excessive emotional stress, which is associated with neurological or psychological problems. There have also been reports of siblings being affected by this syndrome. But there is a need for more research to identify the exact genetic association.”