whatCan you break a heart? The answer given by the Argentine Society of Cardiology (SAC) and the Argentine Cardiology Foundation (FCA) is yes. The expression is not a legend; It can happen and it is important to know what it is to be able to consult in time or help those who present these symptoms.
“Blanca, 55 years old, came to my office after 2 years of being very distressed because after a year of taking care of her sick husband (who had passed away 3 months ago), despite not feeling well, the paperwork and the tiredness delayed your consultation. When I perform the electrocardiogram, I am surprised to find a new scar on his heart (a heart attack). I begin to ask about symptoms: Blanca tells me that two days before her husband died, and in the context of a hospitalization, she felt a very strong pain in her chest with a great sense of anguish, thinking and justifying her ailment as a result of the situation. of stress,” said the Dr. Carolina Salvatori (MN 97.522), cardiologist, advisor to the Clinical Cardiology Council of the Argentine Society of Cardiology.
This is one of the cases that come to the doctor’s office or to a guard, where after a physical stress situation (surgery, intervention) or psychic (separation, mourning, job dismissal, natural disasters or death of pets, among others), all extreme emotions for which a person can sometimes develop a heart attack.
“Although the most common cause of myocardial infarction is atherosclerotic disease, the product of cardiovascular risk factors (modifiable) such as high blood pressure, dyslipidemia, smoking, diabetes, obesity, psychosocial factors, among others, or (non-modifiable) such as genetic history or age, there is the so-called ‘Syndrome of Takotsubo’ (also known as broken heart syndrome) or stress cardiomyopathy, which was described in the 1990s in Japan,” said the Dr. Salvatori.
Takotsubo syndrome
It was named this way because of a domed-shaped vessel with a narrow neck used by fishermen in that country to catch octopus, since it is the shape that the heart acquires after suffering this type of injury, where the apex of the heart stops and is affected. In 85% of the reported cases they are postmenopausal women, who, after suffering an unexpected stress situation (physical or emotional) present an excessive release of adrenaline.
This syndrome is characterized by having a presentation similar to that of myocardial infarctionwith symptoms such as chest pain, shortness of breath, abnormal electrocardiogram, elevated cardiac enzymes, and decreased blood flow to the heart, which in this case is not due to occlusion of an artery by a blood clot as in atherosclerotic disease.
Although the most common cause of myocardial infarction is atherosclerotic disease, stressful situations can also trigger it
In it Takotsubo syndrome the arteries of the heart are almost always normal (confirmed by catheterization, a study that shows the inside of the arteries), but the part of the heart affected by decreased blood flow (usually the apex of the heart) usually initially contracts less forcefully . In most cases this weakness recovers after a few weeks and the heart contracts normally again.
It is important to bear in mind that faced with a situation that our mind considers threatening, the adrenalin it is released immediately to prepare us both to face that situation (fight), and to evade or move away (flight).
Situations that overwhelm people are a risk factor for heart attack
Adrenaline has effects on both the heart (causes tachycardia, which is the increase in pulsation) and a closure on the blood vessels (vasoconstriction), producing by both mechanisms a very important decrease or directly the cessation of the blood flow that feeds the heart muscle.
“In other cases in which the situation overwhelms us, we can even remain ‘paralyzed’ or lose consciousness (syncope), as part of an ancient mechanism for coping with stressful situations,” added the Dr. Julio C. Giorgini (MN 100.308), cardiologist, member of the Council of Psychosocial Aspects and of the Heart and Women Area of the Fundación Cardiológica Argentina (FCA).
A study published by the American Heart Association (AHA)) indicates a higher incidence of this syndrome in middle-aged and older women, in a proportion 10 times higher than in younger men or women. “This study showed the fundamental role and connection between the brain and the heart,” reflected the Dr. Salvatori.
From the Argentine Society of Cardiology and the Argentine Cardiology Foundation They affirm that it is possible to quantify cholesterol, blood pressure and blood glucose levels, but it is difficult for us to quantify how stressed, depressed or sad a person is. Without a doubt, the heart and emotions are related and achieving good stress management is as important as treating ‘classic’ factors such as hypertension, tobacco use, high blood sugar or cholesterol or being overweight.
The incidence of this syndrome in middle-aged and older women is 10 times higher than in young men or women.
The risks after the age of 50
Another important fact to highlight is that after the age of 50 the incidence of cardiovascular disease in women increases gradually with aging and even exceeds that of men, since the protection that female hormones generate over the cardiovascular system is lost. However, replacement therapies after menopause have not shown cardiovascular protection.
“Although the popular belief is that the main cause of death in women is cancer of gynecological origin, this is not the case,” stated the Dr. Salvatori. “Cardiovascular disease is the leading cause of death in women, affecting 1 in 3 women, versus mortality from gynecological tumors that occurs in 18% of cases,” completed the study. Dr Giorgini.
This is not a minor fact, since heWomen do their annual gynecological checkups, but they don’t usually check their heartno. Many times, even the symptoms of a heart attack are confused and minimized thinking that it is just stress.
In another recent 2021 AHA review, the impact on the cardiovascular disease of conditions such as anxiety, unpleasant emotions such as anger, anger, sadness, diseases such as depression or even being pessimistic. It was shown that, together, they increase the risk of having a heart attack by about 30%.
Heart: beware of strong emotions
Outbursts of anger or anger increase the chances of heart attack, stroke, or malignant cardiac arrhythmias up to 20% and most of these episodes occur within 2 hours after the anger or rage attack. Major depression occurs in 5 to 7% of the general population, but reaches up to 15% in people who have had a heart attack.
“On the other hand, also taken as a whole, beneficial attitudes, such as having a positive outlook on life, optimism, meditation and Mindfulness reduce the risk of suffering a coronary event by 18%”, graphed the Dr Giorgini.
After the age of 50, the incidence of cardiovascular disease in women increases gradually with aging
Finally, within the framework of Valentine’s Day, the relationship between physical contact and the heart deserves a separate paragraph. “There are studies that have shown that caresses and hugs generate a safe environment, a greater neural connection between two people and greater activation of the ventral portion of the vagus nerve, strengthening bonds and secure attachment (both in children and in adults). At the cardiovascular level, activation of the ventral vagus nerve (located at the level of the belly) stimulates parasympathetic action, increasing cardiac variability and coherence and decreasing heart rate (less arrhythmias and tachycardia) and blood pressure (less hypertension). , caresses and hugs are good for the heart!” concluded the Dr Giorgini.
