Clues To 'Broken Heart Syndrome'

Source: Society for Cardiovascular Angiography and Interventions
Date: May 13, 2007

Science Daily — The causes of "broken heart syndrome" remain a mystery, but doctors will soon have an easier time recognizing and treating this rare, life-threatening condition, thanks to new data.

Researchers from Brown University in Providence, RI, have developed the largest registry of patients in the United States with Takotsubo cardiomyopathy, informally known as broken heart syndrome because it is often preceded by an emotional or physical shock of some kind and almost always strikes women. One thing is certain: Patients are usually critically ill during the first 48 hours.

"These patients can be difficult to manage for emergency physicians and cardiologists alike," said cardiology fellow Richard Regnante, M.D. "They may be in cardiac arrest, cardiogenic shock, or severe heart failure. They may require advanced life support with airway management and medications to support blood pressure."

In fact, based on symptoms, electrocardiographic (ECG) tracings, and blood tests for heart damage, it often seems as if the patient is having a heart attack. The mystery deepens in the cardiac catheterization laboratory, when the interventional cardiologist finds no blockage in the coronary arteries.

To date, the registry has enrolled 40 patients diagnosed with Takotsubo cardiomyopathy at two major hospitals in Rhode Island over a period of nearly 2½ years. Ninety-five percent were women, and 60 percent experienced some type of stress shortly before coming to the emergency room. The intensity of the stress varied dramatically, however, ranging from armed robbery to a heated argument, tooth extraction, or preparation for a colonoscopy.

"We don't know why some women develop this syndrome after what appears to be minimal stress, while other women experience severely stressful events but don't develop Takotsubo cardiomyopathy," Dr. Regnante said. A surge of stress hormones likely plays a role, he said, but it is also possible that a blood clot temporarily blocks a major artery of the heart, then dissolves before being detected during coronary angiography.

The most common symptom of broken heart syndrome was chest pain, in 70 percent of patients, followed by shortness of breath in 33 percent. All patients had ECG changes suggestive of an acute coronary syndrome, a term that encompasses both heart attack and unstable angina. Troponin-I, a blood test for heart damage, was positive in 95 percent of patients. Twenty percent of patients were unable to breathe on their own and needed a respirator. In all patients, cardiac catheterization showed characteristic abnormalities in the motion of the heart. One patient died of acute heart failure.

The good news is that most patients who survived the first 48 hours had a steady recovery. Thirty one, or 78 percent, of patients had follow-up echocardiography within a few weeks. Heart function was found to be normal in 29 of 30.

Dr. Regnante said that long-term follow-up will be critical to improved understanding of Takotsubo cardiomyopathy. In addition, he and his colleagues are gathering information on patients who have intravascular ultrasound during cardiac catheterization. This imaging test, in which a tiny ultrasound probe is threaded into the coronary arteries on the tip of a catheter, may show whether the patient has clogged arteries or unstable plaques that are not visible on coronary angiography. These findings will help guide long-term treatment.

"Because we don't yet know what causes this phenomenon, we don't know what the best long-term management should include," he said. "As we gather more information on these patients, we can start to understand who is affected by Takotsubo cardiomyopathy, offer more focused long-term care, and make predictions about their outcomes."

This data was reported at the 30th Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI), May 9--12, 2007, in Orlando, FL.

Note: This story has been adapted from a news release issued by Society for Cardiovascular Angiography and Interventions.

As I walk this land with broken dreams
I have visions of many things
Love’s happiness is just an illusion
Filled with sadness and confusion,
What becomes of the broken hearted
Who had love that’s now departed?
I know I’ve got to find
Some kind of peace of mind
Maybe.
The fruits of love grow all around
But for me they come a tumblin’ down.
Every day heartaches grow a little stronger
I can’t stand this pain much longer
I walk in shadows
Searching for light
Cold and alone
No comfort in sight,
Hoping and praying for someone to care
Always moving and goin to where
What becomes of the broken hearted
Who had love that’s now departed?
I know I’ve got to find
Some kind of peace of mind
Maybe.
I’m searching though I don’t succeed,
But someone look, there’s a growing need.
Oh, he is lost, there’s no place for beginning,
All that’s left is an unhappy ending.
Now what’s become of the broken-hearted
Who had love that’s now departed?
I know I’ve got to find
Some kind of peace of mind
I’ll be searching everywhere
Just to find someone to care.
I’ll be looking everyday
I know I’m gonna find a way
Nothings gonna stop me now
I’ll find a way somehow
I’ll be searching everywhere

OFF TOPIC, RaJean sent these notes and I find them to be quite helpful, emphasis in color done by RaJean:

Chuck Pierce gave a quick and FAST synopsis of what he saw for the year ahead. These notes are sketchy because he went so fast. I even missed some of the stuff that was on the power point. Plus this is what stood out to me. Others probably heard things I missed but if you're interested, here's what I got out of it:

We're moving forward with a new gift, with a new freedom.
We need to simplify in our thinking and doing.
It will be a year to break through, be a force and take dominion using various keys.
This year begins with the key of redemption. Yom Kippur is linked with redemption and covering.
By Sept. 24, all the past will be backed up like a river.
Submit means to stand underneath for protection.
This is the day you need to review who your covering is, who will protect you.
It's a day of forgiveness and forgiveness has to do with release and freedom.
A day of buying back. Buy back what has been locked up in times past.
Dominion is to occupy. So take dominion and walk in it.
You are completing one major season in your life and entering another. Do not back up. Don't try to understand it; just step into it.
It's a season of war and the war is intensifying and coming to full manifestation . It's a new season with a new identity and a different war is unfolding.
We will have 7 attacks simultaneously. There was no explanation as to whether these were personal attacks on us as individuals or if they would be terrorist attacks on the nation.
If you understand the time, you'll know what to decree. Just speak it.

There are keys for the next 3 months and we need to be reordered for victory.

Key #1 - This is a great time to reorder your life quickly in any wilderness dimension. In the wilderness, you're always resisting. When the enemy gets stronger, the longer it lasts, there is a danger of slandering your promise. Any unforgiveness you have in your wilderness, get rid of it so you can get out of the wilderness. (He talked about how we have a choice as to how long a "wilderness" lasts - 40 days or 40 years - and that forgiveness is a key to getting out of the wilderness.

Key #2 - This is a time to rebuild the altar.

Key #3 - Ask the Spirit of God to penetrate and remove any deep, anti-Semitic root in your bloodline

Key #4 - If you've been uprooted from your inheritance, ask God to sovereignly set your course of return.

Key #5 - Do not slander the land that you have been given or make light of the promise waiting for you. Numbers 13:32-14:5 - They were a generation which had experienced and been confronted by God but only a remnant actually advanced.

We are moving from glory to glory in this year of 5768. You are being positioned to make a transition into the next realm of glory. The last 2 years actually come together to form this year's momentum. The two symbols of Vav and Zayin (sp?) come together to form the symbol for Chet. The staking of your claim and the sword with a crown actually join together to produce your new beginning. You will begin something new!

This is a year of manifestation. Don't loose site of what you're watching for. Decree them and by March 2008 you will begin to see them. Walk in and under the portals of glory. This is not a time of pioneering. Stay under the portal of glory so the manifestation goes before you and is your rear guard. Move in an expression of worship.
The scepter of the Lord is being extended. By Purim (March 23) God will call you into a place you've never been before. Go!
Rule over the wild beasts: the accusing, mocking voices will be shut down BY GOD. You won't have to shut them down. Dominion will be the key this year.
By January, you will be moving in the new place.
We're entering into our hottest year. There was no explanation as to whether it was the weather that would be hot or that God's people's zeal for the Lord would be hot. He prayed for the latter so that we wouldn't have to experience the former.
Say no to the new and yes to the old and the demon forces will be 7 times stronger.
It is the year of 8: Passion. If you're not passionate about what you're doing, you won't have the strength to conceive life - your future. You must choose FIRE and the zeal of God. Then He'll bring the emotion. If you've refused to change into what God has given you, that will be your "new beginning" instead of the new God intended.
This is the year of momentum. Refuse to have your old cycles repeated.
2008 is a year of new gates opening.
It's a year that God's people will have great authority over their enemies. Stand on the enemy and don't move off of him until you get direction from the Lord. If you do, nations can be driven out of your land. All squatters must go or they gain squatter's rights and their encroachment will remain another season. This is the year to gain your land. Your land is according to your thinking.
Don't be unsound in your thinking.
Subdue your animal impulses.
Find your place of deliverance and do not let any wild beast enter your highway.
It is a year of manifestation.
Don't get under condemnation. The religious spirits are meaner than other spirits.
All poverty mentality must go.
Decree that covenant roots in me are going to realign and open up the supply lines.

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