Broken heart disorder is expanding particularly in Women 50-74

Researchers note 'broken heart syndrome' is increasing under the stress of the pandemic. In the new study, researchers found that since 2006, more and more Americans have been hospitalized for a condition also called stress cardiomyopathy in mental health science. The number of Americans (US) diagnosed with "broken heart" syndrome has steadily increased in the past 15 years. For the most part, more than 88 percent were women, ie those aged 50 to 74 years who had the greatest risk.

"This is like the beginning of vulnerability," said senior researcher Dr. Susan Cheng, of the Smidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles,

The condition called stress cardiomyopathy by doctors looks similar to a heart attack, with symptoms ranging from chest pain to shortness of breath. However, the cause is certainly different. Experts believe fracture syndrome reflects temporary weakness in the heart muscle due to a spike in stress hormones.

This condition may develop within days of an emotionally difficult event, such as the death of a loved one or divorce. However, other stressful situations, from traffic accidents to undergoing surgery, can also be triggers. Most people recover fully from this type of heartbreak, but in rare cases it can be fatal. According to Cheng, stress cardiomyopathy is actually quite rare. According to the American College of Cardiology, there are between 15 and 30 cases for every 100,000 Americans each year. However, the actual incidence is likely higher. This is because people may not seek help for milder symptoms.

Cheng's team found more than 135,000 documented cases of stress cardiomyopathy between 2006 and 2017. The cases continued to increase over time, especially among women aged 50 to 74. In 2006, the condition was barely detected. In 2017, there were about 1,500 cases per million hospitalizations among women aged 50 to 74 years. Meanwhile, women aged 75 years and over also showed an increased incidence of the condition, as did men, although the numbers were much smaller.

Dr Ilan Wittstein, a stress cardiomyopath at Johns Hopkins University, Baltimore, who also led the 2005 study introduced the concept of broken heart syndrome to the wider medical field.

"So thousands of doctors learned about this within a week," Wittstein said.

Hospitalizations for the condition suddenly increased in 2007. The Wittstein study published in the New England Journal of Medicine in 2005 reported 19 cases, 18 of which were women. According to Wittstein, there is one theory that menopausal changes alter the nervous system in a way that puts some women at risk. During times of stress, the smaller blood vessels of the cardiovascular system constrict rather than widen. People with stress cardiomyopathy may have several risk factors for a heart attack. Fortunately, in most cases, the heart's pumping ability is fully restored within a week or two. But in rare cases, people can develop heart failure or life-threatening heart arrhythmias. Common symptoms are chest pain that seems to stem from a heart attack, shortness of breath, and fainting. A clue to the diagnosis is the appearance of the walls of the left ventricle of the heart, its main pumping chamber. When this condition is present, the left ventricle deforms, developing a narrow neck and rounded bottom, resembling a pot of octopus called takotsubo used by fishermen in Japan, where the condition was first recognized in 1990.

Study: Conditions Improve

New research from Cedars-Sinai shows that broken heart syndrome, while still not as common, is not as uncommon as thought. And it's increasing, especially among middle-aged and older women.

This "middle" group -- women aged 50 to 74 -- had the greatest improvement rates over the years studied, 2006-2017, says Susan Cheng.

More than 88% of all cases are women, especially in those aged 50 years or older. When the researchers took a closer look, they found diagnoses had improved at least 6 to 10 times faster for women in the 50-to-74 age group than in the other groups. For each case of the condition in younger women, or in men of all age groups, the researchers found 10 additional cases for middle-aged women and six additional cases for older women. For example, while the syndrome occurs in 15 young women per million per year, it occurs in 128 middle-aged women per year.


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