Mayo Clinic puts new face on 'Broken Heart Syndrome'

Wednesday, July 26, 2006

SCOTTSDALE, Ariz. - More than one woman facing a stressful situation such as public speaking or pressure at work has rushed to her local emergency room, convinced she is experiencing a heart attack. More questions than answers still surround so-called "Broken Heart Syndrome," but a recent study by Mayo Clinic indicates previous theories about the disorder may need to be refocused.

The condition typically strikes women age 40 or older who are experiencing severe anxiety or stress. The women exhibit all the traditional signs of heart attack - chest pain, EKG abnormality, a rise in heart enzymes - but after a short period of time, usually days or weeks, full heart function returns. No specific treatment is indicated, and a recurrence of the problem is unlikely.

"There's a lot of mystery and speculation about Broken Heart Syndrome," confirms R. Todd Hurst, M.D., Cardiology, Mayo Clinic in Arizona, "because what underlies it is not well understood." According to Hurst, researchers have long been aware that important events in the brain can have a significant impact on the heart, "but no one knows exactly how the heart and the brain are inter-related," he adds.

In the case of Broken Heart Syndrome (transient mid-ventricular ballooning syndrome, or left ventricular apical ballooning), it's clear that stress is involved in the onset of the condition. Once the stress is reduced, symptoms disappear and heart function returns to normal.

Hurst is the lead author of a paper on the subject to be published in the Aug. 1, 2006, issue of the Journal of the American College of Cardiology (JACC). He says the Mayo Clinic findings "make some theories less likely, and others more likely."

One popular theory is that women exhibiting Broken Heart Syndrome suffered a problem of the arteries, possibly a spasm of multiple arteries or a dysfunction in the coronary arteries. That seemed consistent, because in more common LV apical ballooning, the lower heart becomes enlarged and fails to move.

But in four cases reported in the article involving women age 37 to 69, Mayo Clinic researchers found that the tip of the heart continued to move normally during the episodes, making arterial dysfunction less suspect. Instead, the midsection of the left ventricle became enlarged and temporarily ceased to function, indicating the presence of a variant to left ventricular ballooning.

The JACC article represents the first description in Western medicine of Transient Mid-ventricular Ballooning Syndrome, and may be helpful to physicians as well as guiding future research.

"It's important for physicians to realize the syndrome exists," says Hurst, "and that it is transient."

Mayo Clinic is a private group practice of medicine dedicated to providing diagnosis and treatment of patient illnesses through a systematic focus on individual patient needs. As a leading academic medical center in the Southwest, Mayo Clinic focuses on providing specialty and surgical care in more than 65 disciplines at its outpatient facility in north Scottsdale and at Mayo Clinic Hospital. The 208-licensed bed hospital is located at 56th Street and Mayo Boulevard (north of Bell Road) in northeast Phoenix, and provides inpatient care to support the medical and surgical specialties of the clinic, which is located at 134th Street and Shea Boulevard in Scottsdale.

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