“Broken Heart Syndrome” Rise During Pandemic: Study

Thursday, July 9, 2020 (Health Day News)-A doctor in a hospital system in Ohio has discovered yet another possible outcome of the COVID-19 pandemic.

This condition, which doctors call stress cardiomyopathy, resembles a heart attack and has symptoms such as chest pain and shortness of breath. But the cause is different. Experts believe that it reflects the temporary weakness of the myocardium due to a surge in stress hormones.

Two hospitals at the Cleveland Clinic also saw a surge in the diagnosis of stress cardiomyopathy during the first weeks of the COVID-19 pandemic.

Nearly 8% of patients arriving in the emergency department with possible chest pain and other heart conditions were diagnosed with stress cardiomyopathy, according to a new study discovered between March and April ..

This was 4-5 times the rate between 1.5% and 1.8% seen in the pre-pandemic period.

COVID-19 can also cause cardiac complications, but none of the patients with stress cardiomyopathy had confirmed infection, said cardiologist Ankur Kalra, who was involved in the study. I will.

“This is not a reflection of the virus, but an indication of pandemic stress,” he said.

Kara cardiomyopathy said stress cardiomyopathy is a relatively new diagnostic method, and doctors are still trying to fully understand it. However, it is nicknamed because it can occur after emotionally difficult events such as the divorce or death of a loved one.

But other stressful situations-from traffic accidents to surgery-may also trigger, Kara said.

However, although the condition may not occur shortly after the trigger, said Dr. David Kass, professor of cardiology at Johns Hopkins University School of Medicine in Baltimore.

Cass said he could develop stress cardiomyopathy, for example, after experiencing an earthquake and dealing with the fear of another person.

This condition is thought to occur when the heart muscle is overwhelmed by a flood of catecholamines, a well-known stress hormone. It temporarily reduces the pumping capacity of the heart.

He explained that this condition is quite different from a heart attack. There are no blockages in the arteries and the cardiomyocytes may stun briefly, but they do not die.

Symptoms mimic a heart attack, said Dr James Januzzi, a trustee of the American College of Cardiology and a cardiologist at Massachusetts General Hospital in Boston.

But as the tests are done, the real cause becomes more apparent.

Januzzi explains that stress cardiomyopathy looks different from a heart attack on the electrocardiogram, which measures the electrical activity of the heart. Also, when a doctor does angiography and looks through the arteries of the heart, no obstruction is seen in patients with stress cardiomyopathy.

The good news, according to Januzzi, is that people with this condition usually have no long-term heart damage and recover quickly.

Given all the stress of a pandemic, from fear of the virus to unemployment to social isolation, it’s not hard to imagine why stress cardiomyopathy increases.

But he also warned the findings: From the beginning of the pandemic, many US hospitals saw a significant decrease in heart attack patients-probably people feared a trip to the ER, in 911. Maybe because I wasn’t calling.

That could be one of the reasons for the increased diagnosis of stress cardiomyopathy, said Cass.

“The denominator has changed,” he said. “So it’s hard to know if this is really happening a lot.”

Januzzi has agreed that this could be a factor.

Interestingly, none of the patients tested positive for COVID-19. Janusi noted that cases of stress cardiomyopathy “associated with COVID” have been reported in infected patients, but the cases associated with the pandemic itself are new.

And it is “very plausible,” he said that these stressful periods can lead to a true increase in the condition.

Januzzi believes that it is important for the general public to address chest pain and dyspnea symptoms. Go to the ER and see your doctor.

Kara agreed. He also urged people to do their best to manage stress-for example, regular exercise or using meditation to calm the mind.

Findings were published online July 9 JAMA Network Open..

For more information

Johns Hopkins Medicine is on Stress cardiomyopathy..