Broken Hearts Club

Article reposted from Penrose Bloom magazine.

Extreme emotional or physical stress can lead to heart attack like symptoms.  In October, Laura Debenham had one of the scariest days of her life.  "I was really sick all day," she recalls.  "And I just kept getting sicker and sicker.  then, I had hot flashes."

She had pain on the side of her chest, and she was having trouble breathing.  She also felt nauseated and couldn't keep food down.  "I went to a website and looked up the symptoms of a heart attack in women, because I'd heard they were different than in me," she says.  Debenham had all but one of the symptoms she read about, so she called 911.

At the hospital, after an EKG and other tests, her doctors thought it was a heart attack.  But once in the cardiac catheterization lab at Penrose Hospital, they discovered she hadn't had one after all.  Rather, she had stress cardiomyopathy, which is often referred to as broken heart syndrome.  "Cardiomyopathy" refers to severe weakness in the heart muscle, which can be brought on by intense emotional or physical stress.

Stress and Your Heart - Left uncontrolled, stress can affect the heart-raising blood pressure and increasing our risk for heart disease and conditions such as stress-induced cardiomyopathy, also know as Takotsubo syndrome.  When a patient has stress-induced cardiomyopathy, the initial symptoms appear the same as a heart attack, says Deborah Jalowiec, MD, a cardiologist with Colorado Springs Cardiologists, A Centura Health Clinic.

"You have EKG changes," Jalowiec says.  "You have elevated cardiac enzymes.  It looks like a heart attack until you get to the cath lab, and there are no blocked arteries."  Stress cardiomyopathy is most common in women-in fact, in a recent study, 89 percent of patients with the condition were women.

"Overwhelmingly stressful situations cause the release of adrenaline, and this quick release seems to be toxic to the heart muscle.  The heart muscle is temporarily damaged," Jalowiec explains.  "It's not a heart attack because the heart muscle will go back to normal."

Stress cardiomyopathy is commonly brought on by a stressful event, like a death in the family, a divorce or separation, the loss of a job, a sudden burst of anger, or intense fear.  But it doesn't always have to be a negative cause, Jalowiec says.  Hearing "surprise" yelled at a surprise party can trigger the adrenaline response as well.

"There can be physical stressors too, such as an asthma attack, a migraine headache, or going into surgery," Jalowiec explains.  "But one out of three people (who experience this condition) cannot identify a stress issue."  Debenham, 51, is one of those.  While she says she lives with day to day stress - she owns and manages a sports bar and is the mother of three children-she doesn't know what specifically caused her attack that day.

Finding relief for stress.  Debenham spent four days in the hospital after her stress induced cardiomyopathy.  Afterward, her doctor put her on medication and gave her some advice.  "He told me to control my stress," she recalls.  "And I laughed."  It's not always easy to get away from stressful situations like your job or family.  But, Jalowiec says, if you are frequently under stress, there are steps you can take when you feel stress mounting.

"This condition seems to be more common in high-strung, anxious people," she explains.  "You can try biofeedback or relaxation techniques to control the adrenaline release."  Of course, she says, recognizing rising stress levels during a stressful or unexpected situation, like attending a funeral or being in a car accident, isn't likely.  But the more you can manage your stress, the better for your heart.

As for medications, beta-blockers can help block the effect of adrenaline on the heart and can be used long term.  ACE inhibitors also may be used immediately after and attack to help the heart muscle return to normal.

Recognize the signs.  Even if you think you might have stress cardiomyopathy, don't wait for the heart to heal itself, because it could be a heart attack.  "You can't tell the difference without a heart catheterization, so if you think you have symptoms, you have to go to the ER," Jalowiec says.

And if it is broken heart syndrome, you should be under the watchful eye of a cardiologist to manage the condition with medications and to make sure there are no serious consequences.  Very rarely, people can develop congestive heart failure or an arrhythmia (abnormal heart rhythm) as a result of the cardiomyopathy, Jalowiec says.

Make sure you get medical care, and try to manage stress in your life.  If you're a high stress person or high stress response person, get that under control," she adds.  Debenham says her daily stress might not be going anywhere, but she enjoys her Denver Broncos tickets and makes time (though she should do it more, she says) for the activities she loves.  "I golf," she says.  "And I love it."

Ladies get yourself checked out if you experience any of the symptoms, don't blow it off and attribute it to heartburn or whatever other excuse you may want to tell yourself.  Prior to changing careers and going to Personal Training school, I had attacks that were thought to be heart attacks.  After many visits to the hospital and calling the ambulance on myself while on duty as a 911 dispatcher, we attributed it to esophageal spasms.  The spasms felt like heart attacks and scared me into making a healthier career decision.  After over 25 years in Law Enforcement and working every shift imaginable, I decided I needed to take a break from the high stress career.  The spasms have subsided and I haven't had one in over 6 years, it worked for me, but only because I listened to my body and then took action.  WM of PBC


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