What becomes of the broken-hearted? Stress and the Human Heart

The Irish playwright, Oscar Wilde, observed that the heart was made to be broken. Indeed, the experience of being alive is almost certain to contain at least one heartbreak, perhaps even adding to the richness of our humanity or sowing the seed of a future happiness. The medical community has long questioned whether heartbreak or its’ frequent companion, severe or chronic physical or emotional stress, can damage the human heart, the muscle responsible for each life sustaining breath. Let’s take a look at possible answers to those questions.

For millennia, doctors have treated patients with physical ailments suspected to be associated with strong emotion or suspected psychological causes. For some, those emotion related ailments might include headaches, stomach pain or just a general malaise. But what about the heart? Decades ago, astute Japanese researchers began to note a pattern of a weakened heart muscle, occurring most often in post-menopausal women who have recently undergone physical or emotional stress (1). Described in 1990 as stress cardiomyopathy and dubbed “Takotsubo Syndrome”, the Japanese name for a plant that resembles the affected heart, this condition often presents with chest pain and possible ECG and blood test changes seen with a heart attack. This can present a diagnostic challenge as the patient is wheeled to undergo a coronary angiogram and unblocking of the diseased arteries, only to find there are no significant blockages at all. In those cases, further investigation will reveal the main pumping chamber of the heart to be weakened, hence the term cardiomyopathy (disease of the heart muscle).

As stated, older women are affected with one study reporting nearly 90% female, with a mean age of nearly 67. Interestingly, and in keeping with the stress component of the cardiomyopathy, higher rates of neurologic or psychiatric disorders (55.8%) were reported in the group with this condition versus the 25.7% presenting with true heart attacks (2).

Cardiomyopathies come in different sub-types and are generally serious underwriting concerns. These concerns relate to a greater risk for more severe and potentially life-threatening arrhythmias. These cases will often be heavily rated or uninsurable. The good news with stress cardiomyopathy is that it is often treatable with common heart medications, with excellent prospects for a full recovery, perhaps in excess of 90% (2). For these cases, the prospects for insurance are also good, though a waiting period or extra premium may still be required.

The mind-body connection continues to challenge medical professionals but continues to provide insight into overall health and enhancing the ability to diagnose and treat certain ailments. Continue to keep up with PPI’s Risk Bits for more news on the mind-body connection and good health.

  1. Kazuo Komamura et al., Takotsubo Cardiomyopathy: Pathophysiology, diagnosis and treatment. World Journal of Cardiology. July 26, 2014.
  2. Christian Templin et al., Clinical Features ad Outcomes of Takotsubo (Stress) Cardiomyopathy. The New England Journal of Medicine. September 3, 2015.

This article is provided by Know the Risk, an educational website that contains underwriting information for insurance professionals, available exclusively to Advisors affiliated with PPI (login required).

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What becomes of the broken-hearted? Stress and the Human Heart