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By Amy Norton<\/b>
HealthDay Reporter<\/i><\/p>\n
THURSDAY, July 9, 2020 (HealthDay News)<\/p>\n
Doctors at one Ohio hospital system have discovered yet another possible consequence of the COVID-19<\/a> pandemic: More cases of “broken heart<\/a> syndrome.”<\/p>\n The condition — which doctors call stress<\/a> cardiomyopathy<\/a> — appears similar to a heart attack<\/a>, with symptoms such as chest pain<\/a> and breathlessness. But its cause is different: Experts believe it reflects a temporary weakness<\/a> in the heart<\/a> muscle owing to a surge in stress<\/a> hormones.<\/p>\n And at two Cleveland Clinic hospitals, diagnoses of stress<\/a> cardiomyopathy<\/a> shot up in the early weeks of the COVID-19<\/a> pandemic.<\/p>\n During March and April, the new study found, stress<\/a> cardiomyopathy<\/a> was diagnosed in nearly 8% of patients who arrived in the emergency department with chest pain<\/a> and other possible heart symptoms<\/a>.<\/p>\n That was four to five times higher than rates seen in pre-pandemic periods, which hovered between 1.5% and 1.8%.<\/p>\n And while COVID-19<\/a> can lead to heart complications, none of the patients with stress cardiomyopathy<\/a> tested positive for the infection, said Dr. Ankur Kalra, a cardiologist who worked on the study.<\/p>\n “That suggests this is not a reflection of the virus, but the stress of the pandemic,” he said.<\/p>\n Stress cardiomyopathy<\/a> is a relatively new diagnosis, and doctors are still trying to understand it fully, Kalra said. But it got its nickname because it may arise after an emotionally difficult event, like a divorce or death of a loved one.<\/p>\n But other stressful situations — from a traffic accident to surgery — can also be triggers, Kalra said.<\/p>\n The condition may not arise immediately after the trigger, however, said Dr. David Kass, a professor of cardiology at Johns Hopkins University School of Medicine in Baltimore.<\/p>\n Kass said a person could, for example, develop stress cardiomyopathy<\/a> after living through an earthquake then dealing with the fear of another one.<\/p>\n The condition is thought to occur when the heart muscle is overwhelmed by a flood of catecholamines — better known as stress hormones, according to Kass. That temporarily reduces the heart’s pumping ability.<\/p>\n The condition is quite distinct from a heart attack<\/a>, he explained. There are no blockages in the arteries, and while heart muscle cells may be temporarily stunned, they do not die off.<\/p>\n The symptoms do mimic a heart attack, said Dr. James Januzzi, a trustee with the American College of Cardiology and a cardiologist at Massachusetts General Hospital in Boston.<\/p>\n But as tests are done, he said, the true cause grows clearer.<\/p>\n For one, Januzzi explained, stress cardiomyopathy<\/a> looks different from a heart attack on electrocardiogram<\/a>, which measures the heart’s electrical activity. And when doctors do an angiogram<\/a> to peer inside the heart arteries, they’ll find no blockages in a patient with stress cardiomyopathy<\/a>.<\/p>\n The good news, Januzzi said, is that people with the condition typically recover quickly, with no long-term heart damage.<\/p>\n Kass said that given all the stresses of the pandemic — from fear of the virus to job losses to social isolation — it’s not hard to imagine why stress cardiomyopathy would increase.<\/p>\n But he also sounded a note of caution on the findings: From the start of the pandemic, many U.S. hospitals saw a significant drop in heart attack patients — possibly because people feared a trip to the ER and were not calling 911.<\/p>\n And that, Kass said, could be one reason why the percentage of stress cardiomyopathy diagnoses rose.<\/p>\n “The denominator has changed,” he said. “So it’s hard to know whether this is actually happening a lot.”<\/p>\n Januzzi agreed that could be a factor.<\/p>\n What’s interesting, he said, is that none of the patients tested positive for COVID-19<\/a>. Cases of “COVID-associated” stress cardiomyopathy have been reported in patients with the infection, Januzzi noted, but cases associated with the pandemic itself would be new.<\/p>\n And it’s “very plausible,” he said, that these stressful times could be leading to a true increase in the condition.<\/p>\n
For the general public, Januzzi said, it’s critical to act on symptoms of chest pain<\/a> and difficulty breathing<\/a>: Get to the ER and let doctors diagnose it.<\/p>\n Kalra agreed. He also urged people to do their best to manage stress — getting regular exercise<\/a>, for example, or using meditation to quiet the mind.<\/p>\n The findings were published online July 9 in JAMA Network Open<\/i>.<\/p>\n <\/p><\/div>\n References<\/p>\n
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\n SOURCES: Ankur Kalra, MD, interventional cardiologist, Cleveland Clinic, Ohio; David Kass, MD, professor, cardiology, Johns Hopkins University School of Medicine, Baltimore; James Januzzi, MD, trustee, American College of Cardiology, cardiologist, Massachusetts General Hospital, and professor, medicine, Harvard Medical School, Boston; JAMA Network Open<\/i>, July 9, 2020, online
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