Broken heart syndrome becoming more common

Betty Winesburg, 69, was helping serve coffee at church over Labor Day weekend when she started having pressure in her chest.

As the minutes ticked by, the pressure increased. She laid down in the back seat of her daughter's car and became nauseated. Her daughter Joy called 911.

When Winesburg arrived in the emergency room, she was told she was having a heart attack. "I'm not having a heart attack," she said. "I think I have a broken heart."

And she did.

Winesburg had stress cardiomyopathy, which can mimic a heart attack. It's when the heart suddenly becomes weak, says David Nagelhout, cardiologist at North Central Heart Institute in Sioux Falls, S.D.

"It typically occurs in middle-aged or older women. They present with classic symptoms of chest pain, shortness of breath and EKG changes that look like a classic heart attack, but on angiogram, their arteries are normal."

It's been recognized in the past 10 years as a heart syndrome, and "we seem to be seeing it more and more," says Nagelhout. It often occurs in relation to severe emotional stress such as the death of a close family member, financial disaster or spousal abuse, he said.

"The first case I saw 20 years ago, I didn't know what it was. A middle-aged woman who's son was arrested, got handcuffed and hauled away in front of her," Nagelhout says. She exhibited signs of a heart attack, yet her arteries were normal.

"I have seen over a dozen cases since then," Nagelhout says.

Winesburg didn't have any of the typical heart attack symptoms. There was no radiating pain or back pain, which is one of the most common symptoms in women having a heart attack, says Addie Graham-Kramer, regional vice president of the American Heart Association.

"I never knew I was as stressed as I was," says Winesburg. But her brother had died in August, a close friend two weeks later, and she was still recovering from a verbally abusive marriage that had ended.

Still her angiogram was good, her cholesterol normal and other heart tests revealed no underlying disease. She spent four days in the hospital and realized she must change her life. Now she exercises regularly, and she's tuned in to how she feels physically and emotionally.

Furthermore, her "shopping cart looks way different." It's filled with fish, regular oatmeal and fresh or frozen vegetables rather than canned. She's scrupulous about her salt intake.

Broken heart syndrome is not well understood, Nagelhout says. "It appears to be an overwhelming surge of stress hormones that causes this to happen with the heart muscle."

The mortality rate is 2 percent to 5 percent. Patients can suffer from the same complications as a heart attack, such as an arrhythmia or the heart stopping. However, "typically the heart comes back within two to four weeks."