Deadly broken hearts

03 December 2019

BROKENHEART

A cartoon of a broken heart

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Question

Can you die of a broken heart?

Answer

Cambridge cardiologist James Rudd took on this question...

James - It is possible, but it's very rare thankfully. There is a condition which is called takotsubo cardiomyopathy, but often people call it broken heart syndrome. It was recognised in Japan in the early 1990s, and the word takotsubo actually means octopus pot; it's a kind of octopus trap that was used in ancient times in Japan. And this is a condition that can be brought on by things like bereavement of a spouse or a loved one. Some trauma, being involved in a terrorist attack, has also caused this. It's extremely rare, but it does... the symptoms the patients have seem to be very similar to heart attacks. Interestingly, people have also described it after happy events in their life, surprisingly. So I've seen a patient who has won the lottery and then has developed very severe pain in the chest and come into hospital thinking they're having a heart attack.

Chris - Ah. So it's the symptoms; but if we do blood tests, which would normally mark up someone who's having a heart attack, are they negative then?

James - The blood tests are positive because there is damage to the heart. But if we, if we look at the arteries around the heart, like we normally would do - where there's a blocked artery causing a heart attack - what we find in broken heart syndrome is the arteries are completely normal, but the heart is not beating. The top part of the heart beats normally; the bottom part is blown out like this octopus trap that the Japanese doctors first described.

Chris - So what do we think is going on then?

James - Nobody knows for sure. People think it's likely to be due to a sudden surge of adrenaline as you would get in a very stressful situation, either a positive or a negative stressful situation, and also the way that the heart is innervated by the nervous system. Because the top part of the heart seems normal; it's the bottom part that is almost stunned, really, and it's just not working at all, and causes, as I say, symptoms of chest pain and breathlessness.

Chris - Wow. How do you spell that octopus trap again?

James - Takotsubo.

Chris - Wow. Thank you for teaching me something brand new. I'm going to impress everyone with that now.

James - The good news is, I should say, is it almost always gets better on its own. So you don't need to do anything apart from just to give patients some pain relief.

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