We all know that we think and act differently than men, and recently many cardiologists are discovering that our hearts think and act differently too. Consider "Broken Heart Syndrome" or Takotsubo's Cardiomyopathy, a type of heart attack that affects women many more times than men.
We’ve all heard about the typical causes of heart disease and heart attacks from high blood pressure and too much cholesterol, but what about those atypical scenarios when someone suddenly has a heart attack seemingly out of nowhere?
Consider Katherine, a woman I met recently who was stranded by the side of the road, waiting for Triple A, fuming because she was late for an important meeting. By the time the mechanic arrived, she started to feel a burning pain between her shoulder blades. Then the pain radiated around to her neck and jaw. She knew this wasn't good, but didn't know what it was until finally after her car was towed and a friend picked up her. Her friend didn't like what Katherine was saying about the burning pain in her jaw, and so despite Katherine saying that it was nothing, and to please just take her home, her friend did the right thing and headed straight to the Emergency Room.
By the time Katherine arrived, her testing revealed that the burning was from a type of atypical (unusual type) of heart attack.
What happens
This is more common in women after menopause than it is in men. Takotsubo’s typically occurs after a severe and sudden emotionally stressful event. It can be from anger, anxiety or from a happy event. We think it happens when there’s a flood of adrenaline and other “fight or flight” neurochemicals that leads to a rapid response in the heart.
It’s believed that the flood of stress hormones causes the coronary arteries to constrict which reduces blood flow to the heart muscle. And yet, because of the "fight or flight response" the heart is trying it's best to pump harder and harder to supply the needed oxygen and blood to the body, but there's less oxygen and blood flow available for the heart to do it's work. These 2 opposing factors results in a heart that’s trying to pump more blood without enough oxygen, which leads to the muscle in the lower part of the heart (the ventricles) bulging out abnormally at the bottom. The blood doesn't pump efficiently this way.
Other scenarios
There are cases Takotsubo's, where women who have come home, opened their door after a long day at work and discovered all of their friends shouting “Happy Birthday" and then collapsing. And not just fear, there was even a case reported of a woman who had inherited a substantial amount of money and was at a reception signing a big check for $ 1 million dollars to her favorite charity when she suddenly had Takotsubo’s and had to be rushed to the Emergency Room.
Takotsubo's? Interesting name, what does it mean?
When this was first described in Japan, the bulging at the bottom of the heart on angiogram looked just like an octopus pot, which is how it got it’s name Tako Tsubo’s or Octopus Pot.
Why we can see it now?
In the past, before we had advanced imagery that could look at the heart muscle, cardiologists could only guess at what was happening. Now with echocardiograms and angiograms that are performed right away, Takotsubo’s or Broken Heart syndrome can be identified and the typical bulging of the ventricles can be seen.
Though Takotsubo's is rare, luckily most women recover from it and go on to lead normal healthy lives. However in our over-stressed, go, go, go world, more and more women are experiencing all sorts of heart conditions brought about by numerous factors, including stress.
What's important to know:
For women, the signs of a heart attack can be very different.
Yes, you may have a crushing chest pain, but you might also have:
• Shoulder pain or pain between the shoulder blades
• Burning pain in your arm, neck, jaw or between your shoulder blades
• Sweating
• Sudden fatigue
• Nausea
• Indigestion and burning
• Pain that comes with exercise and then goes away when you stop
When in doubt, don't wait and don't try to figure out what it is on your own. Go to your nearest emergency room. It saved Katherine's live and it just may save yours or someone you love.