A 'broken heart' is not just a period of emotional sadness. In some cases it is a traumatic physical event.
Takotsubo cardiomyopathy is informally known as 'broken heart syndrome' because it often occurs due to an emotional or physical shock. It almost always happens to women and patients are typically in a critical state during the first 48 hours.
"These patients can be difficult to manage for emergency physicians and cardiologists alike," says Brown University cardiology fellow Richard Regnante, M.D. "They may be in cardiac arrest, cardiogenic shock, or severe heart failure. They may require advanced life support with airway management and medications to support blood pressure."
Based on electrocardiographic tracings and blood tests for heart damage, patients seem to be having a heart attack but cardiologists find no blockages in the coronary arteries.
A recent study monitored 40 patients diagnosed with Takotsubo cardiomyopathy at two major hospitals in Rhode Island over a period of nearly 2½ years. 95% were women and 60% experienced stress before coming to the emergency room.
Unfortunately, the types of stress were not consistent. There is no easy correlation between a bank robbery and a colonoscopy.
"We don't know why some women develop this syndrome after what appears to be minimal stress, while other women experience severely stressful events but don't develop Takotsubo cardiomyopathy," said Regnante. Possible other causes were a blood clot temporarily blocking a major artery, then dissolving before being detected.
It may just be that something is fundamentally different about women and men and how they handle stress, love and depression.
In this Virginia Commonwealth University study, Love Beats Depression for Women, Not Men, the researchers wrote:
Supportive, loving relationships offer women protection against major depression but don't seem to play a role in male depression
So we may be in the realm of Neuroscience rather than Cardiology. Lovesickness is mental trauma was the theme of a report for The Psychologist magazine outlining the mental relationship between love and depression.
But the physical symptoms are also evident. Ilan S. Wittstein of the Johns Hopkins School of Medicine in Baltimore studied 19 patients who seemed to have heart attacks after stress situations but had healthy arteries and found that all but one were women and most were older. They all had stress hormone levels (like adrenaline) two to three times as high as the actual heart attack victims and seven to 34 times higher than normal.
"Our hypothesis is that massive amounts of these stress hormones can go right to the heart and produce a stunning of the heart muscle that causes this temporary dysfunction resembling a heart attack," Wittstein said. "It doesn't kill the heart muscle like a typical heart attack, but it renders it helpless."
So love may make you helpless in ways you never expected.