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Stress-Related Broken Heart Syndrome on the Rise During COVID-19

July 29, 2020

Photos of isolated family members separated from each other to prevent the spread of COVID-19 are wrenching, but new evidence shows the actions spurred an increase in the cases of Broken Heart Syndrome in the pandemic’s first wave.

Also known as takotsubo cardiomyopathy, Broken Heart Syndrome (BHS) can occur after extreme emotional distress. Symptoms mimic a heart attack and changes in heart function are evident on echocardiograms.

“Yet, when we perform an angiogram to see if there is a blocked artery, the arteries are normal or have mild abnormalities that wouldn’t cause a heart attack,” explained Dr. Jared Selter, medical director of the cardiac catheterization laboratory and interventional cardiology at St. Vincent’s Hospital in Bridgeport. “Broken Heart Syndrome is a diagnosis of exclusion once you have eliminated heart attack.”

BHS, he said, is caused by surges in stress hormones from extreme emotional stress. According to a Cleveland Clinic research team, in work published in the Journal of the American Medical Association Network Open, there has been a significant increase in BHS cases since the onset of the pandemic.

The researchers analyzed data from 1,914 patients coming into two Ohio hospitals with urgent heart issues during the pandemic. None tested positive for COVID-19 but, when compared against the same timeframe last year, the number with BHS jumped from 1.8 percent to 7.8 percent.

This, Dr. Selter noted, makes sense for several reasons, such as:

  • Lack of experience with a pandemic. “These are unprecedented times. People cannot rely on experience or memory to help them cope. Some people are legitimately scared for their own lives and the lives of their loved ones. Without a timeframe of how long this pandemic might last, a vaccine or viable treatment, the stress people are experiencing continues to grow,” he explained.
  • Polarizing, politicized reality. The virus, and people’s reactions, generates conflict. Imagine, Dr. Selter said, a relative who refuses to wear a mask or social distance, even around someone with risk factors.
  • Increased isolation. Social distancing leaves people feeling they lack social support while grappling with emotional stressors.

Anyone struggling with increased stress, depression or social isolation is encouraged to talk with a primary care or mental health provider about help. In addition, being creative about maintaining contact with loved ones and friends can help.

“This is important even beyond the realm of BHS,” he said. “Social connections are going to be very important to avoid depression, anxiety and other medical issues.”

Symptoms that there’s cardiac trouble – either BHS or a heart attack – are the same, including:

  • Chest pain or pressure.
  • Shortness of breath.
  • Fatigue.
  • Pain in the jaw, arm, shoulder or shoulder blade.
  • Bad gastrointestinal symptoms.

Anyone experiencing these symptoms, Dr. Selter said, should seek emergency medical attention in case it is a heart attack. BHS typically responds to heart attack treatments – aspirin, beta blockers to curb the adrenaline storm affecting the heart, ACE inhibitors, angiotensin receptor blockers and diuretics.

“Most patients will recover with this medical therapy. Hospitalized patients may need support devices to help the heart work while it is impaired,” he said.

Patients are generally followed by cardiologists after discharge to make sure the heart is stabilized.

For more information on Broken Heart Syndrome, click here

In an emergency, call 911. For help with anxiety and depression, click here.

Not feeling well? Call your healthcare provider for guidance and try to avoid going directly to an emergency department or urgent care center, as this could increase the chances of the disease spreading.

Click here to schedule a virtual visit with a Hartford HealthCare-GoHealth Urgent care doctor.

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