When Freud and Sorrow hit the heart
Broken heart syndrome and happy heart syndrome can manifest themselves clinically as a heart attack and lead to an acute heart weakness. There is therefore often a risk of misdiagnosis between the two diseases.
Stuttgart – An alleged myocardial is not what it is, but a Broken Heart syndrome in almost five to ten percent of the cases. Or, as we know, we are dealing with a happy heart syndrome. The parallels between the two syndromes and a myocardial infarction are astonishing as far as the symptoms and the acute pump weakness than a heart attack,” says Cardiologist Wolfgang Rottbauer from the University Hospital Ulm. Despite all the progress made in recent years, about 30 percent of the heart attack and probably the Broken Heart syndrome patients still die before they arrive in the hospital. In both cases, hospital mortality is about five to six percent. “These figures are scary high,” said the medical doctor of Ulm.
In order to improve the prognosis of the patients, a correct diagnosis is very important. While a heart attack is usually the result of arteriosclerotic deposits in the blood vessels, there is no closure of the coronary vessels in the two syndromes. “It is rather a temporary contraction disturbance of the heart, which leads to an acutely diminished pumping are typically significantly restricted in their mobility. “It is as if the heart had fallen into a winter star,” says cardiologist Jelena Ghadri from the University Hospital of Zurich. Looking closely at the wall movements, however, it becomes clear that there are four different types of motion disturbances. “The most common disorder is when the heart looks like a Japanese clay jug, a so-called
professor Christian Templin, have analyzed the data from 485 European and US patients diagnosed with Broken Heart Syndrome. The data all come from a register, which was founded in 2011 (www.takotsubo-registry.com) and has been fed with information from around 30 centers around the world. The first results were published in 2015 in the New England Journal of Medicine. In 96 per cent of the patients, the medical practitioners found that heart attack-typical symptoms such as chest pain and dyspnea appeared directly after negative emotions: this could be the sudden death of the spouse, bullying at the workplace or a sudden accident in the family. “In the meantime, however, we also know that physical events such as surgery, cerebral haemorrhage, or narcosis in people with a certain predisposition may also trigger a Broken Heart syndrome,” Ghadri reports. However, the syndrome can remain unrecognized, especially in the case of physical causes.
In a subsequent fine analysis, it was found that around four percent of all patients were an emotional stressor such as the birth of a grandchild, a surprise party, a favorite rugby team victory, a cracked lottery jackpot, or the like. Similar to the Broken Heart Syndrome, one speaks here of Happy Heart Syndrome. Why only four percent? “We suspect it needs a stronger stimulus for it than for Broken Heart heart syndrome and Broken Heart syndrome are approximately the same.
Frequently, it affects women in the menopause
But how does it happen that emotions that are processed in the brain cause a “winter star”? “Brain and heart talk about nerve fibers. And the signals thus reaching the heart cause the ability to contract themselves to be interfered with, and the puttering function is restricted. This disorder may arise because the smallest blood vessels cramp up, “Ghadri said. More is currently known about the axis brain-heart yet. Also why women are particularly affected after the menopause is unclear. The hormones alone, according to Ghadri, are probably not. Perhaps it is important that women are more emotional than many men. Broken heart and happy heart syndrome are not only very similar to a heart attack in the symptoms: “The ECG and the heart-typical enzymes like the troponin are altered in the same way as in the heart attack,” says the cardiologist. It is only by means of a heart catheter examination that it is possible to make the exact diagnosis of infarction or syndrome.
The Takotsubo syndrome is by no means as benign as initially thought. “There may be dangerous complications such as ventricular fibrillation and respiratory arrest during the hospital stay in about five the heart muscle to recover fully. The problem is that the probability of recurrence of an acute pump weakness is high. “We currently have no way to prevent such an event,” says Rottbauer.
Every minute counts
Although beta-blockers have a positive effect on the stress lines between the brain and the heart, they do not seem to be effective enough to avert the two syndromes. says Rottbauer. According to Ghadri, however, it is advisable that patients reduce their. Relaxation techniques might help here. Both Ghadri and Rottbauer recommend that those affected be as careful as possible in the case of emotional events, as long as this is possible, and to carry out regular inspections. And most importantly: “In acute breast pain, syndrome patients should visit a hospital as soon as possible or call the emergency physician. Just like a heart attack, every minute counts, “advises Rottbauer.