February has been designated as National Heart Month in both the UK and the US. National Heart Month aims to raise awareness of the symptoms and causes of various heart diseases, and gives advice to the public about their cardiovascular health.
According to statistics compiled by UK charity the British Heart Foundation (BHF), seven million people in the UK are living with cardiovascular diseases (CVD). Although death rates are falling, there were approximately 152,000 deaths from heart and circulatory diseases in 2017, which is equivalent to one death every three minutes, making CVD responsible for 25% of all UK deaths.
Approximately 28.1 million adults in the US were diagnosed with heart disease in 2016, which is 11.5% of all adults, according to the Centres for Disease Control and Prevention. Although the American Heart Association states CVD death rates have declined by 71.1% since 1968, heart disease remains the leading cause of death, claiming 635,260 lives in 2016.
One of the lesser-known heart conditions without treatment options is takotsubo cardiomyopathy, which is commonly referred to as broken heart syndrome as it is often triggered by emotional distress, such as bereavement, domestic abuse or financial worries.
What is broken heart syndrome?
According to heart muscle charity Cardiomyopathy UK, broken heart syndrome affects around 2,500 people in the UK every year; the majority of patients are women over the age of 50.
The condition causes the left ventricle of the heart, the main pumping chamber, to enlarge and change shape, which weakens the heart since it cannot pump blood to the body as well as it should.
Its official name, takotsubo cardiomyopathy, derives from the Japanese name of a traditional fishing pot used in Japan to trap octopi, which is similar to the shape of the heart of broken heart syndrome patients; Japan was where the first case was recorded in 1990.
Broken heart syndrome has similar symptoms to a heart attack, including sudden intense chest pain, shortness of breath and arrhythmia, but without blockages in the arteries.
It is usually a temporary condition with sufferers’ hearts returning to normal within a few days or weeks. However, in approximately 10% of cases the condition returns following full recovery and 20% of patients experience heart failure.
Studies have found that the mortality of patients who had been previously diagnosed with broken heart syndrome is often caused by non-cardiac disorders, such as intestinal occlusion and respiratory failure, and therefore independent of the condition.
How to fix a broken heart: researching possible treatment for broken heart syndrome
Since the exact mechanism of action of broken heart syndrome is unknown, there are currently no treatments indicated specifically for this form of cardiomyopathy.
To promote heart muscle recovery and control, broken heart syndrome patients are usually prescribed beta blockers, angiotensin converting enzyme (ACE) inhibitors and diuretics.
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However, the BHF has funded research projects at Aberdeen University looking into possible therapeutic targets that would aid patients suffering with the condition.
One study completed in December 2018 used MRI scans to discover higher levels of inflammation in the heart muscle and blood of broken heart syndrome patients than healthy volunteers up to five months following the event.
Aberdeen University associate medical director Professor Metin Avkiran said: “Surprisingly, there are still large gaps in our knowledge of its underlying biology. The discovery that it is accompanied by inflammation within the heart and in the rest of the body is an important step forward.
“We now need further research to understand if inflammation causes takotsubo cardiomyopathy and determine if drugs that target inflammation could be the key to fixing broken hearts.”
New York University (NYU) School of Medicine’s Cardiovascular Centre is currently recruiting for participants in a clinical trial named Tako-Breathe that explores the efficacy of daily deep breathing sessions for well-being, improving function of the parasympathetic system and reducing the risk of future heart attacks or death.
The study was designed because previous NYU research had shown that women who have experienced broken heart syndrome had abnormalities in the parasympathetic nervous system, which regulates unconscious functions while the body is at rest.
Researching and then developing treatments for broken heart syndrome is relatively urgent since Aberdeen University researchers have found that patients’ hearts do not necessarily spontaneously recover with time.
Lead researcher and chair of cardiovascular medicine Dr Dana Dawson said: “Further investigation is now required as only by finding out exactly what causes this condition will be able to start thinking about how to treat it so that patients can enjoy better follow-up care.”