How Coronavirus Is Causing a Wave of ‘Broken Heart Syndrome’

The stress of the pandemic has wide-reaching consequences

The novel coronavirus (COVID-19) pandemic has been challenging for healthcare providers and researchers partly because of how much is unknown about the virus and our evolving understanding about what sort of damage it can do to the body. 

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Now, experts at Cleveland Clinic have uncovered yet another consequence of the pandemic: the rise in cases of a heart condition that is often referred to as “broken heart syndrome.”

While not a direct symptom of the coronavirus, this syndrome saw enough of an increased presence in the early days of the pandemic that doctors explored the connection between the two. What they found was disquieting.

What is “broken heart syndrome”?

“Broken heart syndrome,” or stress cardiomyopathy, occurs when physical or emotional distress causes dysfunction or failure in your heart muscle. Because symptoms include chest pains and shortness of breath, those experiencing an episode think they’re having a heart attack. Other symptoms include irregular heartbeat, low blood pressure and fainting.

Experts still don’t fully understand what causes an episode. But physicians believe a person’s reaction to physically or emotionally stressful events releases stress hormones that temporarily reduce the heart’s ability to pump – causing it to contract less efficiently or irregularly instead of in a steady, normal pattern. Hence, the nickname “broken heart syndrome.” 

The difference between an episode of stress cardiomyopathy and a heart attack, though, is that unlike with heart attacks, the patients don’t have blocked coronary arteries. And most patients who experience stress cardiomyopathy make a quick and full recovery and there’s rarely major damage to the heart.

That’s not to say it’s totally harmless; it has sometimes been known to cause a major cardiac event and, rarely, death. But most patients generally recover within a few days and are treated with medicine that lowers their blood pressure and slows their heart rate.

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How coronavirus factors in

When you’re talking about stressful events, a global pandemic surely qualifies. Whether it’s worrying about loved ones who are at risk, job loss, trying to balance work-from-home and family, the isolation of quarantine or any number of other aspects of the outbreak, live the last few months has, really, been nothing but stress.

And it’s that stress that cardiologist Ankur Kalra, MD, says might be leading to the presence of stress cardiomyopathy in COVID-19 patients. 

“The COVID-19 pandemic has brought about multiple levels of stress in people’s lives across the country and world. People are not only worried about themselves or their families becoming ill, they are dealing with economic and emotional issues, societal problems and potential loneliness and isolation,” says Dr. Kalra.

“The stress can have physical effects on our bodies and our hearts, as evidenced by the increasing diagnoses of stress cardiomyopathy we are experiencing,” he adds.

In fact, Dr. Kalra led a study, recently published, to see if there were more instances of stress cardiomyopathy during the pandemic than before and the results won’t surprise anyone who’s found themselves at wit’s end thanks to the pandemic.

What the study found

The study looked at 1,656 patients who presented with acute coronary syndrome, spread across four two-month periods prepandemic (March-April 2018, January-February 2019, March-April 2019 and January-February 2020) versus 258 similar patients from March 1 through April 30, 2020, during the early stages of the pandemic. 

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Not surprising, there was a higher rate of stress cardiomyopathy during those pandemic months than before. According to the study, 7.8% of patients hospitalized during the coronavirus outbreak (20 of the 258 patients) were diagnosed with “broken heart syndrome”. 

By comparison, the stress cardiomyopathy rate during those four prepandemic periods was just between 1.5 and 1.8%, between 5 and 12 patients per period. 

Not only that, but patients admitted during the pandemic period were in the hospital longer with the median stay lasting 8 days. For those prepandemic periods, the average hospital stay was 4 days in two of them (March-April 2018 and 2019) and 5 days in the other two (January-February 2019 and 2020). 

Focus on self-care

It’s been a repeated point of concern throughout the pandemic, but the study underscores the need to focus on self-care, especially for patients who may be more prone to high levels of stress. 

“While the pandemic continues to evolve, self-care during this difficult time is critical to our heart health, and our overall health,” says cardiologist Grant Reed, MD, MSc.

“For those who feel overwhelmed by stress, it’s important to reach out to your healthcare provider,” he adds. “Exercise, meditation and connecting with family and friends, while maintaining physical distance and safety measures, can also help relieve anxiety.”

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