Roberta Heale Associate Editor @robertaheale, @EBNursingBMJ

For many of us, our hearts fill with joy as the holiday season settles upon us.  For many others, this time of year includes sadness or stresses so strong they can break a heart. I recently travelled to visit a friend who had suffered the loss of her husband and then soon afterward had been hospitalized for chest pain and shortness of breath.  After numerous investigations, she was told that, thankfully, she didn’t have a heart attack.  Rather, she was diagnosed with broken heart syndrome.

Broken heart syndrome, also called stress-induced cardiomyopathy or takotsubo cardiomyopathy, is a real phenomenon where extreme physical or emotional stress can lead to chest pain and shortness of breath.  Unlike with a heart attack, the blood vessels of the heart are not blocked with broken heart syndrome, but the blood flow in the heart may be diminished.  Most people have a full recovery but, in a small number of cases, it can lead to short term, severe cardiac muscle failure and death . https://bit.ly/2QDkFgI

The exact cause of broken heart syndrome isn’t known however, it could be a result of a surge of adrenaline, or other stress hormones that may temporarily damage the hearts of some people. The trigger for broken heart syndrome can be an extremely stressful emotional event, such as death of a loved one, or physical event, such as emergency surgery. The catalyst can even be something positive, but also stressful, such as winning a lottery. Some medications may provoke broken heart syndrome (duloxetine, levothyroxine, epinenphrine, venlaxafine).  People over the age of 50 and women are more prone to broken heart syndrome as are those with neurological or current psychiatric issues. https://mayocl.in/2z4qBGf

There is no way to tell if the chest pain that a person is having is a result of broken heart syndrome or other cardiac event. Immediate transfer to emergency services is a must, where investigation and treatment can be administered.  It can take up to 6 months to fully recover from an event.   There may be ways to prevent a reoccurrence of broken heart syndrome such as in managing stress levels, or taking beta blocker medication to reduce the impact of stress hormones on the heart.  https://mayocl.in/2z4qBGf

The holiday season can be a time of extreme stress.  Keep this in mind and take care of yourselves and your loved ones and enter into the new year both happy and healthy.