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A Bermudian brought to light Broken Heart Syndrome

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Fixing broken hearts: Dr. Ian Wittstein of Johns Hopkins Medical Center

The first story I ever covered that made me cry was one on the theft of a grouper from the Aquarium. I’m fairly tough and while I like animals I’m not an animal activist. But someone stole the grouper that had been in that tank for more than 20 years. They killed it, filleted it and left the bones there in the tank with another grouper. That showed a complete lack of true fishing skill.That didn’t make me cry. It made me angry.But the next day, the other grouper in the tank, the female, well she died. The Aquarium said she died of a broken heart. Groupers are apparently monogamous and stay with their partners for life. I had never heard this and it made me so sad I cried.It’s not just a romantic notion or the stuff of movies or confined to the fish world, we, too, can really die from a broken heart. Dr Ian Wittstein, Assistant Professor of Medicine at Johns Hopkins University School of Medicine, said Broken Heart Syndrome was nicknamed such at Johns Hopkins.And the condition actually came to light with a Bermudian patient. Dr Wittstein, in an interview with Body & Soul, said back in 1999 a Bermudian patient who was believed to have had a heart attack, was sent to the Baltimore, Maryland hospital for catherisation (a procedure which shows the actual heart chambers, muscles and surrounding arteries).“She had chest pain and her heart was pumping weakly,” he said.Dr Wittstein was the woman’s cardiologist and he said he and other physicians were stumped when the woman’s heart and surrounding arteries looked completely healthy.“The main reason a person has a heart attack is because a blood clot forms in a main artery that leads to the heart a coronary artery,” he said.Due to the blockage the blood flow decreases and the heart muscle, starved of blood and oxygen, weakens. This is a heart attack.But those suffering with broken heart syndrome also have weak heart muscle.“If you don’t know about it, it looks like a heart attack,” said Dr Wittstein. “The primary symptoms are the same as a heart attack, pain down the arm, nausea, chest pain, and once they get to the hospital, their blood work will also show signs that they are having a heart attack. Their heart muscle will look weak,” he added.But because there are no blood clots or other blockages in the arteries, these patients are actually experiencing something quite different.Dr Wittstein said he noticed that his Bermudian patient’s heart was pumping in an unusual pattern. This observation was key and is the way cardiologists today are able to determine whether a person is having a heart attack or whether they are suffering with Broken Heart Syndrome.According to Dr Wittstein, while overall the heart was pumping weakly, the bottom portion of the heart’s ventricle chambers would be pumping normally while the muscle at the top of these chambers was weak.He said when he noticed this he asked his patient what had been going on in her life and learned that she had been upset at the recent death of her mother. He said he and other cardiologists were soon able to link this distinctive heart pattern to emotional trauma.“We’re able to ask patients as soon as we saw this pattern: ‘Did something stressful just happen in your life?’,” he said.And in all cases they found patients had experienced something that upset or frightened them severely. It may have been the death of someone close to them, an accident, a near miss traffic accident, being held up at gunpoint or anything that greatly shocked them. In fact Dr Wittstein said he had one patient who was so surprised at her surprise 60th birthday party that within a few hours she was rushed to hospital with a suspected heart attack that turned out to be Broken Heart Syndrome.The condition is as serious as a heart attack when it happens. This is because the heart may be pumping so weakly that parts of the body become starved of blood and oxygen. Some people may need the aid of a respirator and treatment in an intensive care unit in order for them to stabilise.The good news however, is that in Broken Heart Syndrome heart muscle does not die (it does in heart attacks). According to Dr Wittstein it’s as if it is stunned temporarily. After a few weeks the heart muscle can completely return to it’s normal strength and the patient is completely well again.“Often patients become stressed as to whether this will happen to them again,” said Dr Wittstein, “and they ask if there’s anything they can do or any medication they can take to prevent it from happening again,” he added.There is no medication and there are no activities that will lower your risk of the syndrome except having a genuine ability to be calm.Broken Heart Syndrome is characterised by the sudden weakness of heart muscle. According to Dr Wittstein it is not something that can build gradually over a few weeks or months. It is also more prevalent in females than males, and post menopausal women rather than young women.

Fixing broken hearts: Dr. Ian Wittstein of Johns Hopkins Medical Center