Suffering from broken heart syndrome? Blame your brain
Can you die of a broken heart? Yes, and scientists have linked it to something happening in the brain.
Broken heart syndrome, also known as Takotsubo syndrome (TTS), is a rare, reversible condition that mimics a mild heart attack.
Despite the name, TTS can be triggered by all manner of stressful or shocking events - think bankruptcy, the death of a loved one, divorce, or even winning the lottery - which cause a surge in production of stress hormones.
As a result of the stressful event, one part of the heart temporarily enlarges and doesn’t pump as well, while the rest of the heart pumps normally or with more force to compensate.
Heart linked to the brain
Previous research has found that people with TTS also have higher levels of activity in a particular region of the brain involved in stress response, called the amygdala.
What hasn’t been understood is whether this brain activity is caused by the syndrome or occurs before it.
To find the answer Shady Abohashem, a nuclear cardiologist at Harvard Medical School, and his colleagues performed retrospective analysis of full-body PT and CT scans of 104 patients, 41 of whom had developed TTS since their first scan.
The team found that the level of activity in two regions that reduce the effect of the stress response - the temporal lobe and the prefrontal cortex - was associated with an increased risk of developing TTS two years earlier than those with lower levels.
What this means
“We can now show that this syndrome happens as a result of chronic stress over years that makes you vulnerable to developing the syndrome more easily and sooner than [less stressed] people,” Abohashem said.
The study also suggests that this chronic stress could prime the heart to overreact to stressful events, leading to this increase in the risk of TTS.
Other experts who were not involved in the study also found the results promising.
“This study confirms our suspicion that there’s a relationship between amygdala activity and future risk of Takotsubo,” said Janet Wei, a cardiologist at Cedars-Sinai Medical Center in Los Angeles.
She added that the results “necessitate further study to see why these patients have higher amygdala activity and how it actually regulates the acute response.”
Image: EUR HEART J, DOI:10.1093/EURHEARTJ/EHAB029, 2021