What Is Broken Heart Syndrome—And Why Is It Disproportionately Affecting Women During COVID?

What Is Broken Heart Syndrome—And Why Is It Disproportionately Affecting Women During COVID?

by Sue Jones
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Reports of new research suggest an increase in a medical phenomenon colloquially known as broken heart syndrome during the COVID-19 pandemic. And experts say this stress-induced heart health condition is mainly impacting women.

Broken heart syndrome is a generally rare, typically temporary heart condition triggered by sudden, intense emotional or physical stress, according to Deepa B. Iyer, M.D., assistant professor of medicine at Rutgers Robert Wood Johnson Medical School and primary physician on the Advanced Heart Failure, VAD and Transplant Team at Robert Wood Johnson University Hospital. This stress can lead to rapid-onset cardiomyopathy, or weakening of the heart muscle. The syndrome was first identified in Japan and is hence referred to as “Takotsubo cardiomyopathy.”

“Takotsubo is a word for an octopus trapping pot used by Japanese fishers which has a narrow neck and a round wide bottom. This pot resembles the shape of the weakened left ventricle of the heart when seen on cardiac echocardiograms or other imaging studies in these patients with broken heart syndrome,” Dr. Iyer tells SELF. (This health issue is also known as stress cardiomyopathy.)

On February 7, ABC News reported that research teams at Cedars-Sinai in Los Angeles, Johns Hopkins University, and the Cleveland Clinic have all been tracking “a recent surge in cases” of this syndrome during the pandemic. Although the data collection is still in progress, past research on this topic during the pandemic backs this up. In a July 2020 JAMA Network study, researchers found that cases of broken heart syndrome had increased after COVID-19 emerged. The researchers analyzed data from 1,914 patients at two Cleveland Clinic hospitals with acute coronary syndrome (a range of conditions linked to sudden decreased blood flow to the heart). Some had acute coronary syndrome pre-COVID, and others presented with the syndrome during COVID. The researchers found an incidence of 7.8% of stress cardiomyopathy during the pandemic, compared with before the pandemic, when incidences ranged from 1.5% to 1.8%. “It has been an underrecognized and misdiagnosed condition, and the emotional and physical stressors during the COVID pandemic have resulted in a resurgence of reported cases,” Dr. Iyer says.

While the study authors were careful to point out that the results cannot necessarily be generalized for various reasons—the patients only representing Northeast Ohio, for instance—they did suggest a few reasons for the potential connection between the pandemic and broken heart syndrome. Importantly, none of the people with stress cardiomyopathy in the study had COVID-19. But the experts believe that COVID-related factors like income loss, unemployment, and grieving loved ones could be behind the increase.

Jennifer Wong, M.D., a cardiologist and medical director of non-invasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, has treated many patients suffering from the syndrome, particularly during the pandemic. “I’ve had numerous patients who are attending a funeral and have these symptoms,” Dr. Wong says. “The pandemic has been a stressful situation, so it’s not surprising that conditions directly affected by mental stress would increase. When there’s a situation of increased stress, we do tend to see these sorts of stress-induced heart conditions spike,” Dr. Wong tells SELF.

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