Achy Breaky Heart

04.03.14

Recent Study Links Occurrence of Natural Disasters to Increase of Medical Heartbreak

Yes, your heart really can break, and tragic events play a role. A recent study shows a correlation between natural disasters and “broken heart syndrome.”

Day-to-day heartache doesn’t hold a candle to scientifically proven heartbreak—a real thing called Takotsubo cardiomyopathy. Turns out, your cardiac muscle can temporarily enlarge and weaken, and what’s more, the number of diagnoses is growing, leading a team of researchers to examine the cause. They found a surprising correlation that has the power to impact each and every one of us, even if you think you’ve got heart health on lock.

First described in Japan, broken heart syndrome got its name because a diagnosed patient’s left ventricle balloons to resemble the shape of an octopus trap. In non-doctor speak, the condition is essentially an impermanent weakening of the heart, often triggered by extreme emotional or physical stress—anything from losing a job to surviving a tsunami. Some physicians postulate a similarity to the fight-or-flight response; stress hormones paralyze the heart, affecting muscle tissues and blood vessels, and impede proper contraction of the left ventricle.

Patients with the condition may experience chest pain, shortness of breath, and other false evidence, such as biomarkers and electrocardiogram changes, bearing the markers of a cardiac arrest.

Though some studies have been conducted internationally, the latest research from the University of Arkansas—which explores a synergy between natural disasters and cases of cardiomyopathy—is unlike any other stateside. Dr. Sadip Pant, an internist at the university and the lead investigator of the report, explains, “This is the first study of its kind in the country.  We have so many hurricanes and storms…but not one has described the spiking of the cases after natural disasters.”

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His team used a nationwide hospital discharge database to identify a group of more than 20,000 diagnosed cases. When they mapped them out geographically, the results indicated “clusters” of broken heart syndrome patients around sites of recent tragedies. Essentially, the data illustrates a notably larger number of reported cases in areas that had seen a natural disaster.

Missouri and Vermont possessed the highest number of reported cases, and the latter, with 380 cases per million residents, had more than double most other states. The data came from the same year Hurricane Irene wreaked the worst havoc Vermont had seen in decades. Similarly, the “cluster” in Missouri occurred near the site of 2011’s massive Joplin tornado. And while there might have been a number of other factors affecting these results, the general research takeaway suggests natural disasters can strongly contribute to cardiomyopathy.

The correlation was first noticed after the 2004 earthquake in Japan, and since then plenty of other global examples have popped up on the radar. Dr. Pant says, “There have been cases reported from Australia after the great flooding. Similarly, people from France described increasing cases after a village burned down.”

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Looking at the bigger picture, the study’s implications are significant when viewed in light of the increasing number of natural disasters on the whole.  According to a 2013 report from the New England Journal of Medicine, the scale of these events is expanding, with three times as many from 2000 through 2009 versus those recorded from 1980 through 1989. Climate-related events account for nearly 80% of the increase, indicating that climate change may affect our health in more ways than we anticipated. The journal also notes that since 1990, “natural disasters have affected about 217 million people every year,” which just goes to show the importance of furthering our understanding of medical heartbreak.

As if you needed another reason to worry about global warming.

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Climate changes aside, there are smaller immediate shifts we can make today, namely prepping response teams for future catastrophic incidents. Dr. Pant’s most important takeaway is the need for further education amongst physicians. Emergency room staff—often the first to see patients affected by natural disasters—and cardiologists need the background knowledge required to properly diagnose the syndrome, because its symptoms usually resemble those of a heart attack. Misidentification of the problem means a delayed legitimate diagnosis—no small thing when it comes to matters of the heart. While the syndrome is largely reversible, Takotsubo also requires careful attention during its acute phase. 

Dr. Pant says, “It’s really important to have widespread knowledge of this disease, not just among cardiologists, but among the other medical specialties, so they can detect in time and diagnose accurately after.”

A properly diagnosed cardiomyopathy patient usually mends—like most romantic heartbreak—within a month or two.