Have you heard the expression, “She died from a broken heart”? Doctors know it is more than a myth or an old wives’ tale. In fact, the condition is colloquially known as “broken heart syndrome.” The medical term for the condition is Takotsubo cardiomyopathy (TCM), named after a pot used by Japanese fishermen to trap octopi.1
The diagnosis was first introduced by a Japanese scientist in 1991. However, this was only the first time it had been described since people had been known to suffer from the condition. After the paper was published, several more cases appeared over the next 10 years, but it remained largely unrecognized outside of Eastern culture, as many of the papers were written by Japanese scientists.
After the earthquake in Japan on October 23, 2004, 16 people were diagnosed with TCM. This large number in such a short period of time drew attention from those in the West. The name “broken heart syndrome” was coined in the early 2010s, in reference to those who experienced the condition after the death of a loved one.
While doctors recognize TCM, no one knows for sure how or why it happens. Doctors know that it can be caused by serious physical illness, surgery or stressful situations that prompt extreme emotions.2
Broken Heart Syndrome Rising During COVID-19 Pandemic
The mounting stress and lack of control that have been hallmarks of the COVID-19 pandemic caused researchers from Cleveland Clinic to investigate the incidence of TCM in a population of people admitted to the main Cleveland Clinic campus and Cleveland Clinic Akron General.3
The cardiologists gathered a cohort of 1,914 patients who presented with acute coronary syndrome both before and after March 1, 2020.4 There were 258 in the group who went to the hospital between March 1, 2020, and April 30, 2020; the others were seen before the pandemic was announced. These became the control group, which was separated into four groups by date. With the post-pandemic-announcement group, altogether there were five groups for comparison.
After an analysis of the numbers of individuals, the researchers found there was a significant increase in people who were evaluated for TCM during the intervention period. This reached an incidence of 7.8% versus a range of 1.5% to 1.8% seen before the pandemic, across the four groups in the control.5
In addition to the increased numbers of people being treated for this, the data showed that those who presented with stress cardiomyopathy during the pandemic experienced lengthier hospital stays but had no difference in mortality. Dr. Grant Reed from Cleveland Clinic, and an author on the study, was quoted in a press release:6
"While the pandemic continues to evolve, self-care during this difficult time is critical to our heart health, and our overall health. For those who feel overwhelmed by stress, it's important to reach out to your healthcare provider. Exercise, meditation and connecting with family and friends, while maintaining physical distance and safety measures, can also help relieve anxiety."
It May Feel Like a Heart Attack, But It Isn’t One
Doctors from Cleveland Clinic say people with TCM often experience symptoms that feel like a heart attack. These can include shortness of breath and chest pain. However, after testing and examination, their coronary arteries are open without any damage to the muscle from lack of oxygenation.
A person may also experience different symptoms, including an irregular heartbeat, low blood pressure and fainting. On examination and testing, doctors may find the left ventricle is enlarged. Doctors believe a physical reaction to emotional or physical stress increases the release of stress hormones that may briefly lower the heart's effectiveness at pumping blood.
Although stress cardiomyopathy and a heart attack may look similar, patients who experience TCM generally recover in a few days or weeks and the condition is rarely fatal. Occasionally, patients have presented with other, more serious cardiac and cerebrovascular events triggered by TCM.
Typically, physicians will treat high blood pressure and give medication to slow the heart rate. Additionally, Cleveland Clinic reports that medications may be prescribed to manage an individual’s stress level. Cardiologist Ankur Kalra led the study and said:7
“The COVID-19 pandemic has brought about multiple levels of stress in people’s lives across the country and world. People are not only worried about themselves or their families becoming ill, they are dealing with economic and emotional issues, societal problems and potential loneliness and isolation.
The stress can have physical effects on our bodies and our hearts, as evidenced by the increasing diagnoses of stress cardiomyopathy we are experiencing.”
One unexpected and famous case some have speculated could be attributed to broken heart syndrome was the death of actress Debbie Reynolds shortly after the death of her daughter Carrie Fisher, who died from a heart attack in 2016.8
Although Reynolds died from a stroke, following a smaller stroke she’d had months earlier, the proximity to a major emotional stress lends credence to the potential that the cerebrovascular event was triggered by stress cardiomyopathy.
As Stress Levels Soar, Failing Economy Raises Risk of More
The American Psychiatric Association conducted a poll in March 2020 and found that 36% of people living in the U.S. believed SARS-CoV-2 had a severe impact on their mental health and 59% believed there was a serious impact on their day-to-day life.9
Some of the top concerns were a negative effect on their finances, fears of running out of food, medicine or other supplies, and fears that the pandemic would leave long-lasting effects on the economy. As the Cleveland Clinic team found, successfully coping with stress is more important now than ever. Yet, according to the Annual Stress in America 2020 survey:10
"The average reported stress level for U.S. adults related to the coronavirus pandemic is 5.9. When asked to rate their stress level in general, the average reported stress for U.S. adults is 5.4.
This is significantly higher than the average stress level reported in the 2019 Annual Stress in America survey, which was 4.9, and marks the first significant increase in average reported stress since the survey began in 2007."
The psychological impact of the pandemic continues as the stressors that affect mental health, such as isolation and lockdowns, are replaced with apprehension about returning to public life.
A review of the research by scholars at King's College London revealed that during quarantines, people have heightened fears of infection, greater levels of frustration and boredom and inadequate information with which to make sense of it all.11 Once the quarantine is lifted, this may shift to stress over financial loss and fears of being treated with suspicion or being avoided by others who are anxious about getting sick.
Experts also know there's a strong connection between financial challenges and mental health problems; this includes suicide. During the Great Depression, suicide rates reached an all-time high,12 peaking again in 2008 to 2010 when at least 10,000 “economics suicides” happened.13
The mental health hotline run by the Substance Abuse and Mental Health Services Administration had a 1,000% increase in April 2020 as compared to April 2019.14 Benjamin F. Miller, chief strategy officer of Well Being Trust, a national foundation dedicated to mental, social and spiritual health, said:15
“Undeniably policymakers must place a large focus on mitigating the effects of COVID. However, if the country continues to ignore the collateral damage — specifically our nation’s mental health — we will not come out of this stronger.”
Stress Reduction Is Important to Overall Health
The effects of stress are felt throughout your body, from the damage to your heart to the arrival of gray hair. Although, from an evolutionary perspective, the stress response is lifesaving, chronic stress has the opposite effect. Data from a study of siblings show that people who have stress-related disorders are far more likely to develop cardiovascular disease compared to siblings from the same family without a stress disorder.16
The term “cardiovascular disease” does not relate specifically to TCM, but, rather, it includes diseases such as ischemic heart disease, cerebrovascular disease, high blood pressure, heart failure and arrhythmia conduction disorders. More interestingly, within the first year of being diagnosed with a stress disorder, the risk for cardiovascular disease rose even higher, to 64% greater than a sibling without stress-related health problems. The authors wrote:17
“Most people are, at some point during their life, exposed to psychological trauma or stressful life events such as the death of a loved one, a diagnosis of life threatening illness, natural disasters, or violence.
Accumulating evidence suggests that such adversities might lead to an increased risk of several major diseases (including cardiovascular morbidity, injury, infection, and certain autoimmune diseases but not cancer) and mortality, with the largest risk elevations usually noted among people who develop psychiatric disorders as a result of their trauma.”
Chaos Raises Stress Levels — Here’s How to Take Control
One major trigger for stress is the perception of loss of control.18 Whether it’s a loss of physical, mental or financial control, the chaos can increase your stress levels and drive physical illness.
You may reduce your stress levels by taking back a measure of control in your life. One of my favorite techniques to help reduce stress and increase creative problem solving is Emotional Freedom Techniques (EFT). The process is also called tapping and it’s a tool that can help free your mind to fully address challenges without fear.
Taking control of the situation may mean learning more about how the pandemic affects your health and what you can do to reduce the potential risk of severe disease. You’ll find more about this on my Coronavirus Resource Page where you’ll find articles about fighting the illness, the signs and symptoms to watch for and what’s the latest in the news.
One of the strongest strategies you can currently use is to raise your level of vitamin D to between 60 ng/mL and 80 ng/mL. You’ll find a great deal of information in my article, “The Most Important Paper Dr. Mercola Has Ever Written,” plus a link to download a free report to help you and your family effectively raise your vitamin D levels.
It is also important to avoid nonstop or excessive viewing of mainstream media. The news programs make their money on views and clicks. The more salacious and fear-producing the headlines, the higher the readership. However, what’s good for their bottom line is bad for your health.19
If you like staying up to date on the news, pick and choose your programs wisely and watch or read for a prescribed amount of time each day to keep your fear and anxiety levels to a minimum.
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