IN A HEARTBEAT
Every year, some 250,000 Mexicans are rushed to the hospital suffering from sharp pains in their chest, upper body discomfort and shortness of breath, and most of them will be diagnosed with a heart attack.
But a small percent of those patients are, in fact, suffering from a very different type of heart problem, cardiomyopathy, more commonly known as broken heart syndrome.
For years, the established medical community shoo-shooed the idea of broken heart syndrome, but recent scientific research has shown that it may well be a real health concern, and its symptoms appear to mimic those of a heart attack.
“Takotsubo cardiomyopathy (the technical name for broken heart syndrome) is brought on by stress, either emotional or physical,” explained ABC Medical center cardiologist Francisco Azar Manzur.
That stress can be the result of the death of a loved one, a traumatic experience or too much work.
The term came about when researchers began to notice that many patients with the condition were grieving, Azar Manzur said.
Most of those patients had just lost a spouse, parent or child, but in some cases, the condition was triggered by a different type of trauma, such as a major car accident or divorce.
“Any of these types of events can lead to the release of stress hormones like adrenaline,” Azar Manzur said, “and these hormones, in turn, can disrupt the flow of blood in the arteries leading to the heart.”
The disrupted flow of blood can leave a chamber of the heart temporarily empty, making it unable to pump properly and distorting the shape of the heart, he said.
The outcome is that the victim feels like they are having a heart attack.
The good news, Azar Manzur said, is that, in most cases, broken heart syndrome does not cause permanent damage to the heart, which means that many patients are back on their feet and fully functional within a few days of the attack.
Unlike in a heart attack, in which some of the heart tissue actually dies, a takotsubo cardiomyopathy’s heart usually recovers with no long-term impairment.
The bad news is that most cases of takotsubo cardiomyopathy in Mexico go undetected and are treated like heart attacks.
“This is a problem because since they are very different conditions, they require different medical care,” Azar Manzur said.
What does all this mean for a patient suffering from chest pains, shortness of breath or discomfort in one or both arms, back, neck, jaw or stomach?
“If a person has any of these symptoms, they should get to the hospital immediately, because chances are they are having a heart attack,” Azar Manzur said.
And in the case of a heart attack, Azar Manzur said that there is only a six-hour window to treat the condition without permanent effects.
But if the person has had a recent trauma in their life, it is important to let their doctors know about it so that they can determine whether the patient is suffering a heart attack or a case of takotsubo cardiomyopathy.”
— Francisco Azar Manzur, cardiologist at ABC Medical Center
“There is no simple clinical way to determine if the patient is having a heart attack or takotsubo.”
Azar Manzur said that a simple electrocardiogram (EKG) is not enough to determine whether a patient has takotsubo because their erratic heart beat will appear similar to that of a heart attack patient.
“Takotsubo can only be determined by a coronary angiogram, a test which is not always conducted on heart attack patients,” he said.
But if the medical team treating a patient with heart attack symptoms is aware of their recent trauma, they can run the angiogram to check for broken heart syndrome, he said.
Azar Manzur said that takotsubo cardiomyopathy is not a common condition.
Only about 2 percent of patients who appear to be having a heart attack will turn out to be suffering instead from broken heart syndrome.
“Women are more likely to suffer from takotsubo cardiomyopathy than men, and it is most common in women over the age of menopause,” he said.
“Chances are that if you have the symptoms of a heart attack, you are having a heart attack, and you need to seek medical attention immediately. But if you have suffered a recent trauma, be sure to tell your doctors. It may just turn out that you are suffering a broken heart.”
More information
The ABC Medical Center has two campuses. The Observatorio campus is located at Sur 136 No. 116 in Colonia Las Américas (tel: 5230-8000), and the Santa Fe campus is located at Carlos Graef Fernández 154 in Colonia Tlaxcala Santa Fe in Cuajimalpa (tel: 1103-1600).
The ABC is a member of the Methodist International Hospital Network, which is headquartered in Houston, Texas.
For more information, contact the ABC’s webpage at www.abchospital.com.
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