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Broken Heart Syndrome: Why Are Women More Vulnerable

Broken Heart Syndrome, Takotsubo Cardiomyopathy

There is a pretty well-established link between long-term stress and heart disease, which is why physicians often include stress management as part of treatment. But what about acute stress, say from grief? A rare condition commonly called “Broken Heart Syndrome” can occur when one hears shocking news, and new research finds that it is significantly more common in women than men.

The medical term for Broken Heart Syndrome is Takotsubo Cardiomyopathy, taken from the Japanese term for “fishing pot for trapping octopus” because the left heart ventricle of a patient diagnosed with this condition resembles that shape. It occurs when a rush of adrenaline and other stress hormones are triggered and cause the heart’s main pumping chamber to suddenly balloon and malfunction.

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Although the outward symptoms appear the same – chest pain, shortness of breath, irregular heart rhythm - there is no blood vessel blockage as in the case of a regular heart attack.

Dr. Abhishek Deshmukh of the University of Arkansas began studying Takotsubo Cardiomyopathy when he noted that the majority of the patients he treated for the condition were female. Deshmukh used a federal database with information from about 1,000 hospitals. He found that out of 6,229 cases that occurred in 2007, only 671 involved men.

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After adjusting for other heart risk factors, such as high blood pressure and smoking, women appear 7.5 times more likely to suffer from Broken Heart Syndrome than men. It is more likely to occur in women over 55 than in younger women, Dr. Deshmukh determined. It is also, for some reason, more likely to occur in the summer while most heart attacks more commonly occur in the winter.

'It's the only cardiac condition where there's such a female preponderance,' commented Dr. Abhiram Prasad of the Mayo Clinic, who presented additional research on Takotsubo Cardiomyopathy at the American Heart Association annual meeting.

A theory as to why women suffer from Broken Heart Syndrome more often than men has to do with hormones. Estrogen appears to have a protective effect on the heart in some studies. Postmenopausal women are at a greater risk for all forms of heart disease than are women prior to menopause.

Another theory is that men may be better able to handle the chemical surge due to stress because they have more adrenaline receptors on the cells in their hearts than women. Excessive stimulation of cardiac adrenergic receptors has led to cases of transient LV hypocontraction in animals noted researchers from Texas Heart Institute in 2007.

Thankfully, most cases of Broken Heart Syndrome are reversible and the patient fully recovers. Only about 1% prove to be fatal. However, a second episode is more likely, occurring in about 10% of the people in the study.

Sources Include: American Heart Association, Texas Heart Institute
Image Credit: Morguefile.com