What is broken heart syndrome? Be careful with strong emotions

Roscoe Arbuckle – known to the public as Fatty, Gordito – was an American silent film comic actor, extraordinarily famous in his time and mentor to colleagues such as Buster Keaton, Charlie Chaplin and Bob Hope. With million-dollar contracts in Hollywood and at the peak of his career, Arbuckle was accused of the rape and death of the young actress Virginia Rappe during a private party. The case was set up with statements to the tabloid press and the police from a friend of the actress who had previously tried to get money from the comedian.

Although the actor's complete innocence was finally proven – including an unprecedented apology from the court that tried him – the media scandal of the judicial process destroyed his career and plunged him into depression and alcohol. His friend Keaton – who was always by his side – got the Warner studio to give him a new opportunity, but an hour after signing his brand new contract, the wheel of fortune turned again and the unfortunate Arbuckle died of a heart attack. Paradoxical? From the human point of view, certainly, but from biology, not at all.

A heart shaped like an octopus trap
On many occasions, surprises – happy or sad – can significantly affect the heart, producing heart disease whose symptoms overlap with those of an acute myocardial infarction. It is called broken heart syndrome or takotsubo cardiomyopathy. This curious name derives from the Japanese word for octopus trap, since the left ventricle of the heart is deformed, acquiring the shape of this traditional fishing art.

The disease was not scientifically described until 1991 in Japan and constitutes a paradigm of the interaction between emotions, the brain and the rest of the body. The triggers are varied and include strong impressions such as a surprise birthday party, a child's wedding, winning the lottery, the birth of a grandchild, an accident that leaves the car totaled, the loss of a job or savings, and The death of a loved one. It can also appear after surgical interventions or as a side effect of some drug treatments.

Symptoms consistent with those of a heart attack
The clinical picture is similar to that of an acute myocardial infarction, with severe chest pain and difficult breathing and cardiac arrhythmia. Furthermore, clinical tests such as electrocardiogram and blood biomarkers reveal a pattern consistent with a conventional heart attack. However, catheterization does not find any blockage of the coronary arteries.

The current consensus in the medical community indicates that the physiological basis is determined by a sudden elevation of adrenaline due to a hyperactivation of the sympathetic nervous system, which mediates fight or flight reactions. The deformation of the heart during this pathology seems to be determined by differences in the expression of adrenaline receptors throughout the left ventricle.

Few serious cases
Fortunately, broken heart syndrome does not live up to its name and the rate of serious complications is relatively low if there are no comorbidities (presence of other disorders), with no specific treatment necessary.

The injury to the heart is temporary, and it practically heals again on its own in a few weeks. Although some studies suggest that there is a small injury left in the heart muscle that could cause other problems in the long term.

This syndrome has an incidence of 0,02% of hospital admissions, which for Spain, for example, represents about 80 cases annually. It appears mainly in women – 000% of cases – and has also been linked to low levels of estrogen after menopause. In addition to hormonal factors, genetic predisposition and previous psychiatric problems seem to influence the appearance of this syndrome.

Although there is still a long way to go to predict which people are most likely to develop it, a recent study has found significant differences in brain interconnection patterns between people who have suffered broken heart syndrome compared to healthy controls of the same sex and age. . This could open the way to predictive knowledge and possible preventive treatment.

In any case, I would dare to say that the Stoics are completely protected against this syndrome. Perhaps the preventive treatment consists of rereading Seneca or Marcus Aurelius.

Source: The Conversation. Author Antonio José Caruz Arcos, Professor of Genetics, University of Jaén. Featured Image: Source Pexels, Author: Clara