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What is broken heart syndrome?

Broken heart syndrome has a medical name, and that's takotsubo cardiomyopathy. Here's what this means:

What does cardiomyopathy mean?

Cardiomyopathy is a medical problem relating to the heart muscle:

• The 'patho' is taken from pathology.

• The 'myo' refers to muscle.

• The 'cardio' refers to the heart.

What does Takotsubo mean?

Takotsubo means 'octopus pot' in Japanese. The traditional octopus trap in Japan has a characteristic shape. In broken heart syndrome, the muscle in the wall of the heart becomes weakened. The left ventricle - the biggest of the four chambers of the heart, which makes up the tip of the heart - balloons out, taking on the appearance of a takotsubo.

Why does it happen?

As with so much in medicine, there are probably multiple reasons, and nobody is absolutely certain what's going on. It may be related to the position of the coronary arteries, which supply the heart with blood. We do know that in around three quarters of cases, broken heart syndrome comes on after major stress, such as bereavement.

We also know that stress floods your body with adrenaline, the fight-or-flight hormone. Thousands of years ago, adrenaline gave humans the edge, putting the body on high alert and making you better able to run away fast if you met a sabre-toothed tiger. But it comes at a cost. Conditions like anxiety disorders e ataques de pânico are closely linked to excess adrenaline. It's thought adrenaline overdrive may be at least partly responsible for takotsubo too.

But in my experience there's a far less exotic answer to why so many husbands and wives and long term partners die close together. After a lifetime of having someone to keep an eye on you - and your health - you're suddenly left alone. Maybe your loved one reminded you to take your tablets or eat healthily - maybe they did some of the tasks you find most stressful. They probably gave you someone to share your worries with - and as they say, a problem shared really can be a problem halved. That's why family and friends can play such a vital role in helping the bereaved through such a difficult time.

The symptoms of broken heart syndrome are often mistaken for a ataque cardíaco. Your heart can't keep pace with the demands of your body, and the result can be:

• Severa chest pain, often mistaken for a heart attack.

• Shortness of breath due to fluid build-up in the lungs.

• Abnormal heart rhythms (fast, slow or irregular heartbeats).

• Dizziness or collapse due to low blood pressure.

• Occasionally, a stroke or cardiac arrest.

Because people with broken heart syndrome often have severe chest pain, they'll usually be rushed to hospital and have blood tests and heart tests like ECG, echocardiogram e coronary angiography.

A diagnosis of takotsubo is made when heart attack has been ruled out and the typical 'octopus trap' appearance of the heart shows up.

Treatment for takotsubo depends on the symptoms it's causing. For instance:

• If you have fluid on the lungs, you'll get water tablets to help drain it.

• If your heart is struggling, beta-blocker and ACE inhibitor tablets can reduce the strain it's put under.

• If your blood pressure is low, you'll get tablets to stabilise it.

• If you have a cardiac arrest, it'll be red alert to get your heart going. After this, you may be considered for a device called an implantable cardioversion defibrillator (ICD). This is a tiny device placed under the skin of your chest. It tracks your heart rhythm and gives your heart an electric shock if you have another cardiac arrest.

On the whole, the outlook for takotsubo cardiomyopathy is good - at least from a physical point of view. Around 95% of people make a full recovery within weeks with the right treatment.

But all too often, the original trauma that caused your heart to weaken can get forgotten in the drama of hospital admission. It's hugely important to get the right support to help you get over a major life event like bereavement.

O CRUSE helpline is run by trained volunteers who have all dealt with bereavement themselves. They can offer invaluable counselling and support. Your GP can also provide help, including referring you for counselling. Don't hesitate - a healthy mind is every bit as important as a healthy body.