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 Texas : Features : Columns : "The Girl Detective's Theory of Everything"
"Broken Heart" Syndrome
by Elizabeth Bussey Sowdal

Elizabeth Bussey Sowdal
The first week of February the folks at the famous Johns Hopkins University School of Medicine announced their findings on stress induced cardiomyopathy, which they have dubbed "Broken Heart" Syndrome. This is a condition found most frequently in middle aged and older female patients who have suffered sudden emotional stress. The researchers (lead by cardiologist Ilan Wittstein, M.D.) list as common precipitating stressors such things as hearing news of a death, suffering an accident, and armed robbery. Also listed as culprit stressors are such things as (now prepare to be a bit surprised) fear of public speaking, a court appearance or even the shock from a surprise party!

The inclusion of a surprise party as one of the common stressors really surprised me. Imagine that! "Surprise! Oops." But I can see easily how it might happen. I was bringing groceries in from the car the other day, my hands were full, the cat was trying valiantly and with feline determination to trip me, I was juggling my purse and bags and keys and trying to open the door when I caught a little movement out of the corner of my eye. I thought I might have bumped the cat with the storm door which I was trying to keep open with my talented left hip and I glanced back to see. I turned a little to look and came face to face with a great big grin, a shock of curly hair and two mischievous eyes. AAAA! I don’t know where it all went, but for just a second I felt that I was completely empty of blood and air and bones. I felt like I was just a wispy, empty husk waiting for a strong breeze.

"Silent like a Ninja," Davey chortled, for that was who it was. My Dave, the child I have cherished and fed all these years. Funny, funny boy that one! I staggered into the house, dropped my bags in the floor and collapsed into a chair. "Don’t ever," I gasped, "ever do that to me again!" He crowed, he cackled, he bounced on the balls of his Ninja feet and if my muscles had not been, at that moment, the approximate consistency of warm custard, I might have thrown something at his grinning Ninja head.

What might have been happening to me inside, according to Johns Hopkins researchers, was that the sudden shock had caused my body to release floods of catecholamines such as adrenalin and noradrenalin into my blood stream. I am no stranger to the occasional wash of adrenalin through my system, living as I do in a house full of comedians and with a relatively high stress lifestyle, and maybe this was to my advantage. Researchers have found that some people are not so lucky and that the breakdown products of the catecholamines, such as metanephrine and normetanephrine, can stun cardiac muscles effectively enough to cause chest pain, shortness of breath and heart failure. All, you will note, symptoms of myocardial infarction, what we commonly call a heart attack.

Despite presenting with symptoms similar to those of a heart attack, patients with stress induced cardiomyopathy had clinical findings much different than those of a heart attack patient. For the most part the patients were previously healthy, had few risk factors, angiograms showed no blockages in the arteries supplying the heart and cardiac enzymes in the blood were not elevated. ECGs, or tracings of the heart's rythmn, showed normal left ventricle function (at the bottom of the heart), but compromised atrial function (at the top and middle of the heart). Catecholamine metabolites were two to three times higher than those found in patients with a heart attack, and were seven to thirty-four times higher than normal levels. Additionally, MRI scans showed no irreversible muscle damage to the heart and recovery rates were much faster than in a typical heart attack. In most of these patients there was great improvement in heart function within a few days and recovery within two weeks.

This new research on "Broken Heart" Syndrome brings medicine one step closer to the wisdom of "old wives" over the centuries. How many times when you were growing up did you hear your Grandma or Aunts tell about somebody who had a shock that nearly killed her? I am eagerly looking forward to reading a future article explaining in scientific terms that some people suffering a shock really do go white-headed overnight. I may need to sign up as a test subject for that study if these boys of mine keep it up. (www.hopkinsmedicine.org)
© Elizabeth Bussey Sowdal
"The Girl Detective's Theory of Everything" - March 28, 2005 Column
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