Watch out for false heart attacks!

Is chest pain always a sign of a heart attack? Experts answer: "No..." Because, like myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the heart membrane), "broken heart syndrome," also known as a false heart attack, can present with chest pain and be mistaken for a heart attack. Cardiovascular Surgery Specialist Prof. Dr. Bingür Sönmez shared striking information about this little-known condition.

This is how it is triggered!

Broken heart syndrome is a short-term condition in which part of the heart muscle rapidly weakens. This condition is usually triggered by sudden sadness or stress. Extreme joy (winning the lottery, unexpected good news) can also cause a broken heart. Therefore, it is also known as "stress cardiomyopathy."

Difficult to distinguish from a heart attack

Symptoms may begin within minutes or hours of sudden stress. The clinical picture is difficult to distinguish from a heart attack.

Sudden chest pain and difficulty breathing are the main complaints, and arrhythmia, palpitations, low blood pressure and fainting may occur.

Although the course is generally good, the risk of complications should not be ignored and the patient must be monitored in the hospital or even in intensive care in the first days.

Does it cause vascular occlusion?

Broken heart syndrome is a major vascular spasm that occurs after a severe hormonal storm that occurs after sudden stress (loss of a spouse or child, a traumatic divorce, separation from a lover, bankruptcy, job loss, etc.).

It's a condition that mimics a heart attack, but without the presence of a blockage in the arteries. Dysfunction occurs when the left ventricle of the heart balloons after being suddenly deprived of adequate nutrition for a short period of time, but it doesn't cause the same damage as a heart attack.

It's a short-term condition characterized by the sudden weakening of a portion of the heart's muscle (the left ventricle). While the base of the left ventricle contracts strongly, the rest of the ventricle bulges outward, disrupting the heart's ability to beat. In this condition, the heart can't pump enough blood.

It catches women in menopause

80-90% of those experiencing broken heart syndrome are pre- or postmenopausal women. This means it occurs during a time when they are most hormonally vulnerable. It's clear that estrogen protects women against stress hormones.

Here are the diagnostic criteria

The most commonly used criteria for diagnosing broken heart syndrome are the Mayo Clinic criteria defined in 2008:

1-Temporary dysfunction due to ballooning of the left ventricle of the heart,

2- No significant stenosis in the coronary arteries on the control angiography, 3- Infarction findings on the ECG, 4- Paradoxical movement between the upper and lower parts of the left ventricle on the ECHO, 5- Elevated troponin, which is a sensitive laboratory finding of a new infarction, 6- Typical octopus trap appearance on the dynamic cardiac MRI,

7-Differentiation of the diagnosis of myocarditis.

Is it life-threatening?

In most cases, the clinical picture may improve within a few hours or days of hospitalization. Some patients may not remember the triggering stress event. It generally leaves no permanent sequelae. The mortality rate is 1-2% and is usually seen in patients with complications or secondary or tertiary organ problems (COPD, renal failure, morbid obesity).

Although rare, pulmonary edema, left ventricular rupture, heart failure, cardiogenic shock, arrhythmia, ECG block, and death (1-2%) may occur. The recurrence rate is approximately 5-10%.

The hidden danger that threatens the heart

Why is it compared to an 'octopus trap'?

Broken heart syndrome is also known as Takotsubo cardiomyopathy or stress cardiomyopathy. The Japanese word for octopus trap, "takotsubo," refers to the heart's abnormal balloon shape. Japanese fishermen use takotsubo, narrow-necked, wide-bottomed pots, to catch octopuses. They leave them on the seabed with a rope. The octopuses mistake these pots for natural shelter and are unable to enter or exit.

In 1990, Japanese physician Hikaru Sato and colleagues likened the narrowing of the base of the heart's left ventricle and the ballooning of its apex to takotsubo pots. For this reason, "takotsubo cardiomyopathy" is also known as "octopus trap cardiomyopathy."

HOW IS IT TREATED?

There is no specific treatment for broken heart syndrome. Arrhythmia, pain, and heart failure require treatment: - Beta-blockers: Used for arrhythmia and palpitations to calm the heart. - ACE inhibitors: Reduce the workload on the damaged left ventricle of the heart, allowing it to recover. - Diuretics: Used to remove excess water from the body due to developing heart failure. - Blood thinners (Heparin): Used to prevent clots from forming in the heart.

- Cardiac muscle supporting drugs (inotropic agents): Should be used with caution in cardiogenic shock (Catecholamines may worsen the condition).

Broken heart syndrome is a clinical manifestation of the strong connection between the heart and emotional state. Therefore, psychosocial support and stress management should be an important part of treatment.