Heartfelt Emotions

On the same night her husband died of a heart attack, Dorothy Lee nearly died of shock and grief.

Last November, her husband, Richard, was driving on icy south-suburban roads when he suddenly lost control of the car. “His head had dropped to his chest and he was unconscious,” says Lee, who lives in Apple Valley. She grabbed the wheel and finally stopped the car by pressing her foot over his against the brake. Then she called 911 and gave him CPR, but by the time they got to Fairview Ridges hospital in Burnsville, it was too late.

A couple of hours later, as relatives started to gather, Lee grabbed her chest in pain and swooned with dizziness. But she wasn’t having a heart attack. Lee, then 58, was suffering from a surge of adrenaline and other stress hormones that temporarily “stun” the heart, a condition called stress cardiomyopathy, or broken-heart syndrome.

“The Culprit Becomes the Brain”

Researchers in this country have only recently been “discovering” broken-heart syndrome, though in other countries, notably Japan, it was recognized earlier. It’s trickier to detect than a heart attack, and that makes the condition initially more dangerous.

When Lee experienced her stress-cardiomyopathy attack, her blood pressure and heart-pumping capability nearly shut down, just like a heart attack victim’s would. Presented with those symptoms, doctors will sometimes give a patient a shot of adrenaline to raise blood pressure and improve heart function. But because the hearts of stress-cardiomyopathy victims have already been stunned by adrenaline, more can be fatal. “That would have killed me faster,” Lee says.

Another risk was presented by her electrocardiogram (ECG), which showed normal heart function when she was tested. That’s a typical and troubling result, because it means symptomatic women might be sent home from the ER, says Dr. Scott Sharkey, a cardiologist at the Minneapolis Heart Institute who has studied the syndrome. Doctors will only start to see heart function decline via ECG sometime after an initial complaint, usually within two to four hours. “We don’t understand why,” he says.

Right now, the best way to identify stress cardiomyopathy is with an angiogram, according to Sharkey, essentially an X-ray of the arteries. A heart attack occurs when a clogged artery causes part of the heart muscle to die. But Lee’s angiogram, like that of others with broken-heart syndrome, showed no blockage.

“It typically shows that the arteries are wide open, and that, at the same time, the heart’s pumping function is dramatically decreased,” Sharkey explains. “We then can exclude the arteries as causing the problem, and the culprit becomes the brain, basically. I think it illustrates how powerful the brain is in terms of its effects on our body.”