Heartbreak

I looked down at my phone showing the morning consults. The first one seemed pretty straightforward, chest pain, as routine as it could get. I went through the computer records and within the first two minutes, I knew what the next step of treatment needed to be. The blood work had showed damage to his heart and his EKG showed changes consistent with an impending heart attack.

- Dr Dinesh Arab

I walked into the room and looked at Matt. He was my age and was fit for his age. “You need a cardiac catheterisation,” I told him, after reviewing his symptoms and findings. The procedure involves getting into the arteries supplying the heart, either from the wrist, or the thigh. He agreed to the plan and we were in the lab that afternoon. I was surprised to find that there were no blockages. When I looked at his heart function though, a significant portion was not working, consistent with a heart attack.

After the procedure I went back to his room and reviewed the findings. I asked him whether he was under any emotional stress, and he told me about his recent breakup with his girlfriend. “Broken heart syndrome” is a real phenomena, and not something you see only in the movies. Also called “Tako Tsubo” cardiomyopathy, it is one of those enigmatic conditions that we don’t quite understand. Caused by emotional stress, the symptoms, the EKG changes and even the heart dysfunction is suggestive of a heart attack, but the arteries that supply the heart are normal. The cause for a heart attack is normally blockage of blood flow resulting in death of tissue.