I’ve been diagnose of BHS (Broken Heart Syndrome)

“Believe me, when he left I felt a profound chest pain whose explanation I was not able to explain” Actually this chest pain can come together with ST segment abnormalities and transient left ventricular apical ballooning without coronary artery obstructive disease. This syndrome is called Takotsubo cardiomyopathy (TTC) and luckily it has generally a favorable outcome (Mahajani & Suratkal, 2016).

This stress factor triggers an entire variety of emotional feelings.

The electrical activity of the heart can be recorded by a process called electrocardiography (ECG). An ECG procedure measures the small electrical changes by electrodes placed on the skin. These electrical changes produced by the heart muscle give rise to a pattern of depolarization and repolarization during each heartbeat and its characterized by several features (Niebauer & Josef). All the waves contained in this ECG have predictable amplitudes, morphologies and time durations and any deviation from the normal characteristics leads to a potential pathology as it is the case of the ST segment abnormality found in the Broken Heart Syndrome.

Have you ever felt this transient left ventricular apical ballooning?

This characteristic together with electrocardiographic changes and minimal myocardial enzymatic release imitate acute myocardial infarction without significant epicardial coronary artery disease. In 1991, cardiologists in Hiroshima termed this event as “tako-tsubo-like left ventricular dysfunction” as the shape on the end-systolic left ventriculogram seems a tako-tsubo (octopus trap).

Fifteen years later, it was discovered that this syndrome was not limited to Japanese patients (Virani, Khan, Mendoza, Ferreira, & de Marchena). Two new reports (Cramer, De Boeck, Melman, & Sieswerda) confirmed that hard psychological stress was the main cause of this acute but quickly reversible left ventricular systolic dysfunction. A BHS leads to the same tears and pain we might feel when your guy or girl cheats on you or when your brother goes on Erasmus and you miss him so much. However, this BHS includes a key factor, this stress factor triggers an entire variety of emotional feelings. Stress-induced cardiomyopathy is nowadays recognized all over the world and indeed its scientifically correct to state that your heart can be really broke by someone.

Why have scientists take that long to diagnose this BHS?

Immediate coronary angiography in ST-segment elevation acute coronary syndromes became standard practice only a few years ago (Cramer et al.). Actually, The Netherlands has been one of the first to report myocardial bridging associated with takotsubo syndrome (TTS) (Gurlek, van Es, van der Burgh, Galjee, & van Birgelen). The Netherlands was also the first to report an TTS associated with dynamic left ventricular outflow tract obstruction with systolic anterior motion and mitral regurgitation (Cramer et al.).

A BHS leads to the same tears and pain we might feel when your guy or girl cheats on you or when your brother goes on Erasmus and you miss him so much.

If you were thinking there was a sort of magical emotion triggering all these feelings, this might make you feel a bit upset. But actually, if you look at it from a different point of view, this mysterious natural emotion it’s actually completely linked to our chemistry and might exist to help species remain alive.

Cramer, M., De Boeck, B., Melman, P., & Sieswerda, G. J. (2007). The ‘broken heart’ syndrome: What can be learned from the tears and distress? Neth Heart J, 15(9), 283-285.

Gurlek, C., van Es, J., van der Burgh, P. H., Galjee, M. A., & van Birgelen, C. (2007). Full pattern of transient apical ballooning of the left ventricle triggered by minor myocardial infarction. Neth Heart J, 15(9), 310-311.

Mahajani, V., & Suratkal, V. (2016). Broken Heart Syndrome. J Assoc Physicians India, 64(6), 60-63.

Niebauer, E. A. A., & Josef. (2004). Conquering the ECG. doi:https://www.ncbi.nlm.nih.gov/books/NBK2214/

Virani, S. S., Khan, A. N., Mendoza, C. E., Ferreira, A. C., & de Marchena, E. (2007). Takotsubo Cardiomyopathy, or Broken-Heart Syndrome Tex Heart Inst J (Vol. 34, pp. 76-79).