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'Broken Heart Syndrome' Has Increased During COVID-19 Pandemic, New Study Says

Health.com logo Health.com 7/13/2020 Leah Groth
a close up of a logo: Economic, emotional, and social stress may all be playing a role. © Alex Sandoval Economic, emotional, and social stress may all be playing a role.

Ever since the first COVID-19 case was discovered in the US in January, American citizens have been under increased levels of psychological, social, and economic anxiety—and it turns out, the added stress has been detrimental to heart health.

According to a new original investigation, published July 9 in JAMA Open Network, incidences of stress cardiomyopathy—commonly known as "broken heart syndrome," Takotsubo syndrome, or Takotsubo cardiomyopathy—increased among patients presenting with acute coronary syndrome (ACS), or a range of conditions that cause a sudden, reduced blood flow to the heart. 

“The COVID-19 pandemic has brought about multiple levels of stress in people’s lives across the country and world. People are not only worried about themselves or their families becoming ill, they are dealing with economic and emotional issues, societal problems and potential loneliness and isolation,” Ankur Kalra, MD, a Cleveland Clinic cardiologist in the Sections of Invasive and Interventional Cardiology and Regional Cardiovascular Medicine, and the study's lead author, said in a press release. “The stress can have physical effects on our bodies and our hearts, as evidenced by the increasing diagnoses of stress cardiomyopathy we are experiencing.”

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The study, which examined data from two different Cleveland Clinic hospitals in Northeast Ohio, looked at cases of stress cardiomyopathy in acute coronary syndrome patients who presented at the height of the COVID-19 pandemic (March-April 2020), along with four other control time periods in the pre-pandemic days (March-April 2018, January-February 2019, March-April 2019, and January-February 2020). Researchers identified a total of 20 cases of stress cardiomyopathy during the coronavirus pandemic—a significant increase compared to the 5 to 12 cases of stress cardiomyopathy during pre-COVID times.

It should also be noted that all patients during the COVID-19 pandemic tested negative for the illness. Patients with stress cardiomyopathy also had longer hospital stays during the coronavirus pandemic, compared to those admitted to the hospital before COVID-19 hit.

The Cleveland Clinic press release notes that stress cardiomyopathy—which can mimic the symptoms of a heart attack, but is not usually fatal—isn't fully understood. The condition was first described in Japanese medical literature in 1990 as Takotsubo cardiomyopathy, Richard Stein, MD, a cardiologist and professor at the New York University School of Medicine, previously told Health. The reference came from a similarly named vase-shaped pot, used to trap octopus in Japan, “that has a thin neck and balloons out where the body of the octopus gets stuck.” As part of the condition, the bottom of the heart temporarily balloons out and resembles the shape of the traps, he explained. 

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While researchers and physicians aren't entirely sure as to what causes stress cardiomyopathy or broken heart syndrome, they believe it's triggered by a person’s reaction to physically or emotionally stressful events. The body's response to that stress is a release of stress hormones that temporarily reduce the heart’s ability to pump, ultimately causing it to contract less efficiently or more irregularly than its typical pattern. The American Heart Association also says that women are more likely than men to suffer from broken heart syndrome—possibly linked to the stress resulting from the death of a loved one or a divorce.

Luckily, patients with stress cardiomyopathy or broken heart syndrome generally recover in a matter of days or weeks. The condition, which is rarely fatal, is typically treatable with heart medications to lower blood pressure and slow the heart rate in addition to medications that can help manage stress.

However, an increase in the condition during the COVID-19 pandemic shows that, in addition to taking care of your physical health right now, it's also important to prioritize your mental health and stress levels. "While the pandemic continues to evolve, self-care during this difficult time is critical to our heart health, and our overall health,” Grant Reed, MD, MSc, director of Cleveland Clinic’s STEMI (ST-elevation myocardial infarction) program and senior author for the study, said in the press release. “For those who feel overwhelmed by stress, it’s important to reach out to your healthcare provider.” 

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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Video: 'Broken Heart Syndrome' Has Increased During COVID-19 Pandemic, New Study Says (Health)

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