Diagnosing A True Broken Heart
Wednesday - February 14, 2007
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Medical student Stephen Chun
I was looking for a Valentine’s Day story. It is, after all, the day Americans pay tribute to love by gorging themselves silly on millions of pounds of chocolate. It’s the day we put florists back into the black and women everywhere receive gifts of sparkly, heart-shaped jewelry.
Yes, Valentine’s Day is special, in a commercially frenzied kind of way.
So I wanted to find something romantic to share - and eureka! - I thought I’d found it when I learned there really is such a thing as a broken heart.
Broken hearts abound in lore and literature. We’ve all heard stories of lovers or longtime spouses who lose their partner and very soon after die themselves, presumably of a broken heart.
Well, it turns out “broken heart syndrome” is a real medical condition. But romantic? Not so much, once I was set straight on the science of it. For the scoop on that I went straight to the broken heart expert in Hawaii. I visited Stephen Chun at the beautiful new John A. Burns School of Medicine complex in Kakaako.
Chun has found himself the center of attention worldwide ever since he diagnosed a 71-year-old Hawaiian woman with broken heart syndrome. It was the first case ever identified in the Pacific region, quite a coup for a second-year medical student.
The condition, called Takotsubo Cardiomyopathy, is rare, Chun explained, found in only a fraction of heart attack patients.
“Normally the patients, 50 percent to 60 percent of the time, will develop this syndrome because of the death of a loved one.
“In a few hours (after the death) they’ll come to the emergency room very stressed out, complaining of signs of a heart attack like chest pain.”
The patient has all the classic symptoms - the chest pain, EKG changes that look like a heart attack, and their blood pressure will fall. But when doctors look at the coronary arteries there are no blockages. What they do see is that the bottom part of the heart is not beating normally and has ballooned out of proportion.
“What’s really interesting about this,” Chun says, “unlike congestive heart failure, is that it’ll reverse itself.”
In other words, most times the patients’hearts will return to normal. That almost never happens when someone has a major heart attack.
But it isn’t only the death of a loved one that can trigger it. According to Chun, “it’s been caused by earthquakes, by anesthesia, it’s even been caused by eye surgery and dental surgery. Anything that elevates adrenaline can potentially cause it.”
In the case of Chun’s patient, it was the implantation of a pacemaker that brought on the symptoms. It sounds like broken heart syndrome could just as well be nicknamed stressed-out-heart syndrome, or sudden shock syndrome, or super-adrenaline-rush syndrome.
So, in the immortal words of Tina Turner, what’s love got to do with it?
Quite a lot, I think.
Science gives us the medical explanation for what happens to our bodies, but the trigger in more than half the patients is emotional shock. No surprise that love can affect our bodies that way. It can be a force for good and for healing, but it has the power to destroy as well.
But fascinating as it all is, the perfect valentine story actually turned out to be something very different. I was captivated by the recent discovery in Italy of two skeletons, buried about 3,000 B.C. near the city of Verona, home of the doomed lovers Romeo and Juliet. They are thought to be a young man and woman, and they seemed to be locked together in an embrace. Were they lovers? Sister and brother? Man and wife? The only thing we know about them is that they must have wanted to be together, even in death. They lie on their sides, nose to nose, arms tenderly cradling each other in a 5,000-year-old embrace.
The image moved me to tears. It reminded us - and reassured me - that love endures forever.
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