#creativeoutputno.6

Imagine three scenarios. 

First scenario: You can’t breathe. It’s a cold Friday night and you’re locked in your room, covered in blankets, watching sad movies on your laptop, one pint of ice cream on one hand and a spoon on the other, and your tears are falling down your cheeks as you barely swallow and force the sweet goodness down your throat. You cry yourself to sleep. The next day, you don’t want to get out of the house or even get up from bed. But when you finally do, not because you want to but because you have to and because you realize that you have responsibilities that are more important than your breaking heart, you carry on with your daily activities numb, floating, and dreaming. Then you see that someone, the reason why you’re in such a mess in the first place, seeming to be doing a lot better than you. Heck, that person’s with someone else, and you start to question what was so wrong with you that you just can’t be enough. And now you feel that tug on your stomach, your heart skipping a beat, and the shortening of your breath. Anger. Sadness. Loneliness.   

Second scenario: You saw it happen yourself. Shock. Panic. Stop. At first you couldn’t think straight until your shaking fingers dialled buttons and your trembling voice called for help. But it was too late. You lost someone you love. You suddenly feel nauseous, like you’re about to faint. Days after the funeral, people come by and ask you how you’re doing and you answer with the easiest, typical words you could muster. You still can’t believe it. You unconsciously notice things that remind you of that person – clothes, pictures, a certain smell, a time of the day, a date in your calendar, a special place – everywhere. Each thing would trigger a distant memory, a small detail you’re scared to forget and would rather not or at least not yet. And each trigger would come with chest pains. Grief. Sadness. Loneliness.

Third scenario: The streets are dangerous after it hits 6:30 p.m. The road on your way home is famous for a lot of unfortunate events related to crime and sadly for you, your shift ends at 7:00 p.m., meaning you had to walk to your house alone on a very dark and scary path every day. Carrying your keys between your fingers to try to protect yourself from whatever fearsome obstacle or person attacks you, you try to walk faster. You had a stressful day and all you want is to go home and finally get some rest. Almost tiptoeing upon arrival, when you were about to take a breather, opening the lights to your living room, SURPRISE. A crowd consisting of your friends, family and neighbours surprise you with raised voices, a cake and party decorations. Stress. Fear. Shock. Before you could register what’s happening, you find your vision starting to blur and just like that you can’t see anything.

Are any of these scenarios familiar? Maybe you’ve seen such scenes from a movie or maybe you’ve experienced some of them in real life. Between these three situations, there is something similar and odd that happens after experiencing emotional chaos – the physical pain. Some people would consider such pain normal even though they really couldn’t understand the reason why it occurs. Actually, in such occurrences it is possible that you are experiencing a medical condition called stress cardiomyopathy, better known as the Broken Heart Syndrome.

The Broken Heart Syndrome is a condition wherein extreme emotional or physical stress could lead to rapid and severe heart muscle weakness. Its symptoms could be similar to those of heart attack patients which include:

 ·         chest pain

·         shortness of breath

·         dizziness

·         low blood pressure

·         congestive heart failure

·         Arrhythmias or irregular heartbeats

 Such symptoms follow just minutes to hours after the person has experienced intense, and often unexpected, stressful situations.

Despite having similar symptoms, this condition is different from a heart attack. Unlike heart attacks, tests show no signs of blockages in the coronary arteries. Blood tests also show no to mild signs of heart damage. The electrocardiogram (EKG) results don’t look the same either.  

Johns Hopkins Medicine states that in order to understand this condition, one must first define “stress”. Stress is the response of an individual’s body to things that it considers abnormal, including physical abnormalities. When these occur, the body produces hormones and proteins that would help to cope with the stress. For example, in the third scenario earlier, in experiencing shock after extreme fear, the body produces huge amounts of adrenaline to try to defend oneself or escape danger. Due to the sudden surge of stress hormones, or in the case mentioned, adrenaline; the left ventricle, the main heart chamber that pumps blood out to the rest of the body, becomes stunned and enlarges, causing the heart to freeze temporarily leading to poor blood circulation and symptoms that are almost indistinguishable from acute coronary syndrome.

This condition is often triggered by sudden situations that elicit extreme emotions, whether positive or negative. It is also possible that drugs could cause a surge of stress hormones though these only happen in rare cases. Such drugs include:

 •           Epinephrine (EpiPen, EpiPen Jr.), which is used to treat severe allergic reactions or a severe asthma attack

•           Duloxetine (Cymbalta), a medication given to treat nerve problems in people with diabetes, or as a treatment for depression

•           Venlafaxine (Effexor XR), which is a treatment for depression

•           Levothyroxine (Synthroid, Levoxyl), a drug given to people whose thyroid glands don't work properly

 The situation could become quite critical if the heart can’t pump enough blood to meet the body’s needs. It can be life threatening since this syndrome involves severe heart muscle weakness that could also cause heart rhythm abnormalities.

Studies suggest that menopausal women, particularly those in their sixties and seventies have increased risk for broken heart syndrome. People with previous history of heart disease, neurological disorders, and psychiatric disorders also have higher chances of acquiring this condition.  

The good news is that broken heart syndrome is usually treatable and temporary. The effects of the syndrome on the heart are completely reversible as one of the main features of this condition is that the heart is only weakened for a brief period of time with no long-term damage. Since the syndrome improves quickly, if assisted by physicians familiar with this condition, patients tend to make a quick and complete recovery. Initial treatment usually aims to improve blood circulation to the heart. Further treatment may include medicines and lifestyle changes like improving one’s physical and emotional health.

Learning how to manage stress and cope with problems could help in the prevention of this syndrome along with surrounding oneself with supportive people that are easy to share feelings or concerns with.