Stress May Trigger Serious or Fatal Attack
Studies suggest a heart-brain connection

(HealthDay News) -- We've all heard stories of husbands and wives who died suddenly after their spouse passed away. Coincidence? Maybe not.

Research suggests there may be some truth to the notion that people can die of a broken heart.

Dr. Michael O. Sweeney, an associate professor of medicine at Harvard Medical School and director of cardiac pacing and implantable device therapies at Brigham & Women's Hospital in Boston , reported on the case of a 50-year-old woman whose defibrillator delivered a shock to her heart at the exact moment she was visiting her sister-in-law's grave. Had the woman not had the device in her chest, she would have gone into cardiac arrest.

What's more, she had no idea her heart had been shocked until a few weeks later, when Sweeney checked the defibrillator, which had recorded the exact time of the event.

"It tells us that a person's emotional state, operating at a subconscious level, can interact in someone with serious heart disease to trigger a cardiac event," Sweeney told HealthDay .

Stress cardiomyopathy, or "broken heart syndrome," is a condition in which intense emotional or physical stress can trigger rapid and severe heart muscle weakness, according to researchers at Johns Hopkins Medicine in Baltimore , who study the condition.

Emotional stressors such as grief, fear, extreme anger and surprise can cause it, the researchers report. Physical stressors, including stroke, seizure, difficulty breathing or significant bleeding, can bring it on as well.

People might experience symptoms that mimic a heart attack, such as chest pain, shortness of breath and low blood pressure.

In 2005, a team from Hopkins reported results of a study involving 19 people, all of whom had signs of an apparent heart attack after some emotional event, including news of a death, shock from a surprise party, fear of public speaking, armed robbery, a court appearance and a car accident. Their findings were published in the New England Journal of Medicine .

Eighteen of the people in the study were women, 27 to 87 years old. Another group of seven people, each of whom suffered a classic, severe heart attack, served as the control group, for comparison.

The researchers gathered detailed histories and conducted blood work and other tests, including echocardiograms, electrocardiograms, coronary angiograms, MRI scans and heart biopsies. When the groups were compared, researchers found that the stress cardiomyopathy patients had levels of catecholamines, or stress hormones, that were two to three times those of the people who'd had a classic heart attack and seven to 34 times normal levels.

How stress hormones act to stun the heart remains unknown, but there are several possible explanations that will be the subject of additional research, study co-investigator and cardiologist Dr. Hunter Champion, an assistant professor at Hopkins and its Heart Institute, said in a news release. The chemicals might cause spasm in the coronary arteries, they might have a direct toxic effect on the heart muscle or they might cause calcium overload that results in temporary dysfunction.

So far, the medical literature indicates that stress cardiomyopathy primarily affects women, Hopkins reports. It tends to occur in middle age or older women, and it appears to strike suddenly and unexpectedly and resolves quite quickly.

Anyone who frequently experiences symptoms of chest pain or shortness of breath when under significant stress should be evaluated by a doctor, Hopkins advises.

On the Web

Learn more about stress cardiomyopathy by visiting Johns Hopkins Medicine.

SOURCES: HealthDay News ; Michael O. Sweeney, M.D., associate professor, Harvard Medical School, and director, cardiac pacing and implantable device therapies, Brigham & Women's Hospital, Boston; July 2007, HeartRhythm ; Feb. 9, 2005, news release, Johns Hopkins Medicine, Baltimore
Author: Karen Pallarito
Publication Date: July 31, 2008
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