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20/20 Thursday night - broken heart syndrome


fire911medic

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I admire your belief in unconditional love. I don't share it, nor do i believe in it. but thats just me

Be Safe

Race

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If we look at psychological stress from a physiological stand-point, it is quite easy to understand how people can develop medical problems as a result of this stress. What occurs at a physiological level when you endure a very stressful event? First, we have a release of sympathetic hormones. This leads to increased heart rate, increased contractility, increased oxygen demand, and increased blood pressure. While this response was good when that cave bear was chasing our ancestors out of their homes and their bodies needed to perfuse vital organs and utilize that extra cardiac out put to fight for their lives, you can imagine the potential problems that could develop if this continued for an extended period of time. In addition, our bodies release steroids in response to stress. On of the long term side effects of high levels of steroids may be immunosupperssion and increased risk of infection. The physiology behind steroid regulation is actually quite fascinating. It all starts in the brain. A little part of the brain called the hypothalamus releases a hormone called corticotropin-releasing hormone (CRH) in response to all kinds of stressors. Normally CRH is released on a cycle. Levels usually peak in the morning after waking up. CRH acts on the anterior pituitary gland and triggers the release of adrenocorticotropic hormone (ACTH). ACTH acts on the adrenal gland (cortex) and triggers the release of glucocorticoids. Normally rising levels of glucocorticoids will feed back and block the release of CRH. However, I would think that continued severe stress would trigger continued release of CRH. CRH is not only a hormone in this system, but it is also acts as a neurotransmitter. Some people believe that CRH plays a vital role in how the body responds to stress. Forgive me if I got a little long, however, the physiology behind the disease is most interesting.

Take care,

chbare.

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CH

that was interesting very interesting. But it still dont prove the fact that someone can or can not die of a broken heart....

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Itku2er, I am not really trying to prove if someone can "die from a broken heart." I just wanted to help explain some of the physiological responses to stress.

Take care,

chbare.

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I did not see the TV segment, but there is an article on the Johns Hopkins website regarding this syndrome:

http://www.hopkinsmedicine.org/Press_relea...5/02_10_05.html

I agree with Terri....one can die of a broken heart. In agreeing with Terri, I'm not including the stalker/co-dependent type of "I can't live without you," but rather the "I have lived with you for so long that my life is incomplete without you."

I have seen this on several occasions, all of which were married couples who had been married for 50 or more years. In one case, they had been married for 73 years (she was 95, he was 97). When she passed away, he gave up and passed away within months.

It is not my place to judge if their actions are right or wrong, in giving up on life after their loved one dies. However, I can appreciate the pain and emptiness that they must feel. I can also respect the commitment it has taken for a couple to remain married for over 50 years. We don't see too many couples who last that long anymore.

A very interesting syndrome. Thank you for posting this and encouraging discussion and research on it.

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I did not see the TV segment, but there is an article on the Johns Hopkins website regarding this syndrome:

http://www.hopkinsmedicine.org/Press_relea...5/02_10_05.html

I agree with Terri....one can die of a broken heart. In agreeing with Terri, I'm not including the stalker/co-dependent type of "I can't live without you," but rather the "I have lived with you for so long that my life is incomplete without you."

I have seen this on several occasions, all of which were married couples who had been married for 50 or more years. In one case, they had been married for 73 years (she was 95, he was 97). When she passed away, he gave up and passed away within months.

It is not my place to judge if their actions are right or wrong, in giving up on life after their loved one dies. However, I can appreciate the pain and emptiness that they must feel. I can also respect the commitment it has taken for a couple to remain married for over 50 years. We don't see too many couples who last that long anymore.

A very interesting syndrome. Thank you for posting this and encouraging discussion and research on it.

=D> =D> =D> =D> =D> =D> =D>

That is exactly what i was talking about annie.....my grandfather died the day after Christmas.......then in January less than 1 month after his death my Grandmother died...........

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I am with you on this one Terri, I saw it in the life of a friend of mine. His grandparents were married for over 40 or something like that years. The grandfather died of a massive MI, the grand mother, a very healthy person, died six months later. Her health just went down the drain after the funeral.

Sad to see, but you have admire it. Loving someone so much that you can not exist without him or her.

Regards

S

The first double code I ever worked (one of two actually) was a lady who collapsed while we were coding her husband.....we got to the ED and the doc goes, "I knew you were a strange one Steve, but I never realized how strange. Apparently your idea of a good time is dueling codes." :P

I'm guessing the stress is what pushed her over the edge.

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  • 2 years later...

We have had a few patients with this in the CCU this year with the condition being linked to Apical Ballooning syndrome. I was looking after a patient who had had bad news from her son, she got chest pain that night, st segment changed, Trop I went to 2.97. She had what we thought was a NSTEMI however her angio gram showed normal coronary arteries and the TTE showed cardiomyopathy. With medication and rest, her heart had begun the healing process.

I was in a teaching session yesterday and broken heart syndrome came up, shows how often I don't scroll through the old threads as I had been treating these patients and didn't even click to that it was called this syndrome.

Differential Diagnosis, but then that is said as I work in a hospital with access to lab tests and TTE and other procedures, not quite out in the prehospital arena yet lol .

Scotty

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