What is it like to be heartbroken

Can grief break hearts?

It is said that grief can break people's hearts. This is not just a metaphorical description: hearts can actually be damaged by emotional stress. Doctors refer to this phenomenon as broken heart syndrome or stress cardiomyopathy. A study has already provided indications of the connections that exist between the emotional centers, the control of unconscious body functions in the brain and the life-threatening changes in the heart.

Even among the ancient Egyptians, the heart was considered the seat of emotions and even today this idea is still reflected in some terms and idioms: Hearts hurt or are heavy and, they say, you can even die from a broken heart. These expressions also emerge from the observation that there can be a link between emotions and real effects on this organ. In this context, the term broken heart syndrome (GHS) or stress cardiomyopathy was coined for the first time in 1990.

The phenomenon is characterized by a sudden weakening of the heart muscles, causing the left ventricle of the heart to inflate at the bottom while keeping the neck narrow. This creates a shape that resembles a Japanese squid trap (Tako-Tsubo) - hence the third common name for the condition: Tako-Tsubo Syndrome. This change in the heart is life-threatening: patients develop chest pain and shortness of breath and a heart attack threatens. Women are affected more than average - only about ten percent of the cases are men.

Heart problems with a cause in the head?

As the term broken heart syndrome makes clear, the phenomenon occurs in connection with severe emotional states - such as sadness, anger or fear. So it stands to reason that there is a connection between the changes in the heart and the real seat of the emotions - the brain. The researchers led by Christian Templin from the University Hospital Zurich investigated this connection. As part of their study, they examined the brains of 15 GHS patients using functional magnetic resonance imaging (fMRI). The researchers then compared the results with the brain scans of healthy volunteers.

"In GHS patients, we noticed a noticeably reduced communication between brain regions that are responsible for emotional processing and those that play a role in the autonomic nervous system that controls unconscious body functions - such as the heartbeat," reports Templin. "It becomes clear that the brain is involved in the underlying mechanism of the phenomenon," says the scientist. In this context, it has already been suggested that overstimulation of the autonomic nervous system can lead to GHS events. The researchers were able to further substantiate this explanatory approach with their results.

Mental stress that beats on the heart

"It is also interesting that the brain regions that we found comparatively inaccessible in GHS patients are the same ones that are assumed to control our reaction to stress," says Templin. According to him, this could be linked to the propensity to develop broken heart syndrome. "Ultimately, we hope that our research can lead to the development of preventive, therapeutic and diagnostic strategies to improve patient care in GHS," says co-author Jelena Ghadri.

Source: European Society of Cardiology, European Heart Journal, doi: 10.1093 / eurheartj / ehz068

January 19, 2021

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