Broken hearts

Feb 14, 2006
Be careful, a broken heart can kill you
Severe emotional or work stress can trigger heart attacks in healthy people
By Salma Khalik
HEALTH CORRESPONDENT

ON A day devoted to affairs of the heart, here's a bit of sobering news: A broken heart CAN kill.
So, too, can a surprise party... if there's a little too much of a surprise in it. There is truth to the phrase, 'scared to death'.

And that old chestnut, 'you're being worked to death'? That's possible too.

With Valentine's Day today, comes a timely warning from cardiologists at the National University Hospital (NUH): Severe emotional or work stress can trigger heart attacks in otherwise healthy people.
And their study of seven such patients, along with several others conducted by other cardiac centres, seems to confirm what men have long suspected: Women's hearts break more easily.

Women account for more than nine in 10 of these emotional heart attacks, the studies have revealed.

But it is not all bad news.

They also give the answer to that question posed in the popular song, How Can You Mend A Broken Heart?

Time, apparently, does the trick.

A 'heartbreak' attack is different from a 'regular' heart attack, which is usually caused by blocked arteries that restrict blood flow to the rest of the body.

A heart attack induced by emotion or stress, on the other hand, is triggered by a surge of hormones, which causes only the top part of the heart to contract, thus reducing blood flow.

This phenomenon was first discovered by Japanese researchers in 2001.

They called it 'tako tsubo' because, in such an attack, only the top part of the heart contracts, giving it the shape of an octopus trap with a round bottom and narrow neck - called tako tsubo in Japanese.

But time can help the victims of heartbreak - physically, as well as emotionally.

Rush the victim to hospital. If he - or more likely, she - gets there in time, the chances are very good that, within a month, the heart will have recovered its resilience, resulting in a full recovery and no side-effects from the attack.

Senior cardiologist Tan Huay Cheem, one of the researchers in the NUH study, said: 'We have come across cases like this before, but we thought it was caused by a very small clot which disintegrated.'

These victims tend to have typical heart attack symptoms, such as chest pains.

When doctors investigate, they find none of the classic problems, such as blocked or narrow arteries.

Now, when they do an angiogram on the patient and see the heart in the tako tsubo shape, they know they merely need to support the organ till it gets back to normal.

This is done with a balloon pump which helps the heart push blood to the rest of the body.

A study by the Sheba Medical Centre in Israel found that the tako tsubo syndrome caused 2 per cent of all heart attacks in that country, but 6 per cent of those in women.

A study by Johns Hopkins University in the United States found that, of 19 patients who had suffered attacks related to emotion and stress, about half were triggered by news of the death of someone close.

Other causes included surprise parties, armed robbery and even a fear of public speaking.

'The potentially lethal consequences of emotional stress,' the study concluded, 'are deeply rooted in folk wisdom, as reflected by phrases such as 'scared to death' and 'a broken heart'.'

salma@sph.com.sg