Broken heart syndrome

Broken heart

What is broken heart syndrome?

Sudden emotional stress can precipitate a heart disease called ‘Broken Heart Syndrome’ or stress cardiomyopathy. It is a disease of the heart muscle, usually following a major stressful life event like loss of spouse or a dear one. Sometimes it can be associated with another acute illness as well. It may manifest with chest pain or breathlessness and ECG findings may mimick a heart attack. Ultrasound imaging of the heart (echocardiogram) shows a peculiar finding: ballooning of tip of the left ventricle (lower muscular chamber of the heart). Hence this condition is also called apical ballooning syndrome. Though symptoms often resemble that of a heart attack, there is no significant block in any of the coronary arteries (blood vessel carrying oxygenated blood to the heart muscle). Most cases of broken heart syndrome recover over a period of time and heart muscle function is fully regained. For some reason, heart rhythm abnormalities are less common in broken heart syndrome than in a heart attack of corresponding severity. Broken heart syndrome can occasionally be fatal. It may noted that an actual heart attack (myocardial infarction) can also be precipitated by a major emotional stress. But it is different from broken heart syndrome in that there is a blockage in one or more coronary arteries in case of heart attack.

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Heart attack

What is heart attack?

Heart attack (Myocardial Infarction) is damage to a region of the heart muscle, usually due to sudden blockage of a blood vessel supplying oxygenated blood to the region (coronary artery). Though heart attack can occur due to a mismatch between the supply and demand for blood in the region, the usual heart attack which we are familiar with is due to blockage of a blood vessel. Heart attack is different from cardiac arrest. In cardiac arrest, heart stops beating and it is equivalent to death unless the function of the heart is promptly restored either spontaneously or by chest compression and artificial breathing protocol known as cardiopulmonary resuscitation (CPR).

What are the important symptoms of heart attack?

The most familiar symptom of heart attack is severe central chest pain. It is often associated with sweating, fatigue, dizziness and sometimes breathlessness. Rarely there are no symptoms and then it is known as a ‘silent heart attack’. Some unfortunate victims of heart attack develop a cardiac arrest and may die suddenly (sudden death). Sudden death in heart attack is often due to a sudden change in the heart rhythm which makes the heart stand still (ventricular fibrillation). This abnormal rhythm can be treated by CPR and direct current shock using a device known as defibrillator which shocks the heart back into action. An automatic external defibrillator for use of untrained persons, is now available in many public places like airport.

What to do if you think you are having a heart attack?

First and foremost is to take rest and call for emergency support. In regions where an emergency ambulance service is available, it should be called and one should proceed to the nearest hospital. In well equipped ambulances, it is possible to make a diagnosis and start early treatment even before reaching the hospital. After initial assessment by the paramedic, an electrocardiogram (ECG) is recorded. When facility is available, the ECG is transmitted to the receiving hospital where the team is ready for further action even before arrival of the victim.

It is not advisable to travel in a self driven vehicle to the hospital unless you have no other options. This is because occasionally cardiac arrest can occur en route. Moreover arrival in ambulance speeds up management in the emergency department. Traffic worries are also lesser while travelling in an ambulance. This is in addition to the medical support available in the ambulance.