Very often we say so-and-so died of a broken heart, don’t we? What does it really mean? It means, yes, there is something like dying of a broken heart? Find out something more about this slow and steady departure into the mysterious abyss or nirvana of death…goodbye kind or cruel world!

By Pankajbala R Patel

FEW of us know that there is something called a broken heart syndrome and reportedly more women suffer from it. Although I’m sure men too suffer from broken heart syndrome it. Recently, touching my mid-70s I discovered that I was suddenly feeling very low, like my heart has turned into a piece of stone…it felt like a heartache. I thought perhaps I was in danger of an imminent heart attack and almost called for an ambulance to come take me…then, I sat down quietly in some air-conditioned comfort beneath the fan and the heartache eased away.
However, whenever some anxiety pangs visit me the feeling of heartache returns and makes me feel as hard as stone and breathless – it happens after I have been thinking some nasty things about some people or said some angry words to someone! Believe it or not, this is true. These days I am even trying to curse positively so that it doesn’t backfire on me!
This is to say for all of us worry is a most horrible thing. I suppose especially in my case when way back in 2013 upon suffering angina pains during a walk and some investigations later, cardiac tests revealed I had what is called a deadly left ventricular or T-section blocking the smooth operation of my heart. Some good doctors confirmed, “It’s what we call a widow’s block, you get a heart attack you’re gone in seconds, not a chance in hell of living.” One pious doctor even asked me if I believe in Goa? As if I was in this heart trouble because I didn’t believe in God!
Anyway, to cut a long story short when it was confirmed I had no choice but to get myself bypassed at the Asian Heart Hospital in Mumbai…Rs5-6 lakh expenditure later, I was fine. Life moved on till some ten years later last week when I thought I had come full circle with my heartaches coming back to life again. I feel like I don’t want to talk to anyone anymore. The question arose, to die or not to die, like it is in my birth right to live or to die! It is in my hands. Why get into petty meaningless arguments? I asked myself, so that afterwards I feel like a piece of stone in the region of where I imagine my heart is situated. Never mind that heart aching eases; for a while I thought what triggered the heartaches was a meal I’d just overeaten on, some quick-fix junk…so many women take to the nasty habit of ever eating just to ease life’s irritations, annoyances, boredom. It becomes one of those pernicious habits inviting premature health problems like obesity first and the rest of it later. As if one is seeking attention but not seeking it under duress if you understand what I mean. Sometimes just the temptation to sit down and hog on some junk food is itself an aggravation to mind, body, heart and soul.

A nuclear stress test is an imaging test that shows how blood goes to the heart at rest and during exercise. It uses a small amount of radioactive material, called a tracer or radiotracer. The substance is given by IV. An imaging machine takes pictures of how the tracer moves through the heart arteries.

THEN upon consulting Dr Google a bit I learnt that there is really something called a broken heart syndrome and it is party of a cardiomyopathy condition when the heart muscle gets weakened – it more often than not happens because one is unable to handle stressful situations or extreme emotional reactions with some maturity and wisdom. Broken heart syndrome also gets triggered by serious physical illnesses or post-surgery. My homework tells me this broken heart moments are a temporary warning situation although some people continue to feel unwell even after the emergency is over or healed somewhat…deceptively so. Really, so few of us know how to get to the heart of a matter and get down to calling for an outright change of lifestyle scene-scenery as a friend of mine calls it.
BROKEN heart syndrome is also referred to as Takotsubo syndrome in cardiomyopathy – the heart is after all just a muscle which pumps blood and it does get affected by strong emotions or physical stress. You are warned over a period of time till matters come a head or crisis point so to speak, whatever that may be. The symptoms of a broken heart syndrome are chest tightness, shortness of breath, perspiration, and you may feel like you’re in mild or acute state of anxiety or shock. It can be life-threatening sometimes for it can lead to congestive heart failure with low blood pressure.
Clearly we need to take stock of our life and the relationships which aggravate our emotions and affect our state of mind. Broken heart syndrome comes and goes mysteriously until you sit up and take serious notice of it and get to the bottom of what is causing and find the courage to face the truth. Maybe resolve to make a clean sweep of whatever is bugging us over and over again, mostly our own indiscipline which works against us. The general rule is love yourself first nobody how ridiculous it sounds in our cultural contexts (think about it)! We may of course engage with ourselves inwardly and with slow, deep breathing in meditation routinely, take stock of situations, accept the inevitable positive perspective if you can without over compromising…
All this is easy to say, hard to do but try to shun negative emotions and feelings because these influence your hormonal system. In continual distress the stress hormones of cortisol, adrenaline and noradrenaline predominate and the happy hormones of serotonin and oxytocin diminish. Warning physical pain manifests itself. The vagus nerve which begins at the start of the brain stem and connects to the neck, chest and abdomen gets affected, stimulates the anterior cingulate cortex which adds up to trouble.
It was Japanese scientist Sato who first described the condition of broken heart syndrome in 1991. He proved that people do die of acute or intense stress without evidence of any physical injury. A weakened heart muscle or cardiomyopathy also occurs in diabetes, high blood pressure and heart disease patients. This is when the relevant heart chambers neither fill up or pump blood properly and the heart tries to compensate by working harder, the heart muscle in time becomes weaker, thicker, ineffective.
Typically a reduced flow of blood to the kidneys affects them and body tissues start storing fluid in thorax, chest cavity, lungs, leading to shortness of breath and peripheral edema in legs and ankle, bloated stomach ascites. We may continue to feel bloated with the pounding of heartbeats and there is chest pressure dry coughing, especially while lying down to sleep flat or there is an inability to sleep on the right or left side …fatigue dogs you, also a light head and faint dizzy moments.
Smoking, obesity, junk carbohydrate eating packed with all the industrial fats take their toll and soon your arteries narrow and high blood pressure builds up, you will find it difficult to walk with ease. All this will contribute to a weakening heart muscle. In mainstream allopathy treatment doctors will first use diuretics to reduce water retention and blood pressure drugs include such things as ACE inhibitors (ease blood pressure, reduce strain on heart), beta blockers, SGLT-2s, Corlanor (ivabradine), Lanoxin, etc, to support and strengthen your heart. The idea is to keep your blood pressure at 20/80 mcm Hg which is considered normal, but then again as the wear and tear of growing older catches up with you the parameters of fitness also change.
IN CONCLUSION, I would say, beware broken heart syndrome if it is visiting you too often. Old or not so old, if you are plagued by anger, anguish, stress, distress, grief, fear…constantly unresolved issues of life which take a toll on sensitivity and sensibility, do not ignore them or put off dealing with them tomorrow and tomorrow and tomorrow. Sometimes tomorrow never comes. Try not to be judgemental! But work towards pulling yourself together to get rid of whatever is bugging you – hopefully, you will be better of and able to enjoy a gamut of perspectives about what the truth is, what freedom is and not least of all what health is. Most of us are too harsh with ourselves. Sooner or later we must be kind to our own self to move on to live in peace — and it’s not the peace of the graveyard I’m thinking of here, okay.

Common medical tests to check out your heart….
THE increasing number of medical tests today inspire confusion and alarm! It is worth clueing yourself up about some of them at least, the routine ones and some newly introduced.
The electro-cardiogram or ECG is basic and that’s the first test any medical facility or hospital will do, then come the blood tests (familiar and not so familiar). ECG can determine or detect irregular heart rhythms, (arrhythmias) of blocks or narrowed arteries in the heart…indicating coronary artery disease which cause angina pains in the chest upon stress or even at rest.
Then we have the usual echo-cardiogram or ultrasound which is more detailed, there’s an echo 3-D which captures three-dimensional views of the heart structure with greater detail than the 2-D echo. There is a nuclear cardiac stress test, coronary angiogram which is routinely done if heart trouble is diagnosed earlier. There is magnetic resonance imaging or MRI which is expensive but gives conclusive details; there is coronary computed tomography angiogram (CCTA), whatever that is…
Diagnostic tools are far too confusing oftentimes but generally speaking the coronary angiogram is the best, it is a type of X-ray to examine coronary arteries supplying blood to your heart muscle, for confirming artery disease. There’s criticism that medical facilities indulge in needless angiograms and badly diagnosed patients prove later to be not heart patients at all – after the damage is done!
Needless to say few patients know enough to question doctors in charge who may be in a hurry to make decisions either honourably or dishonourably to bill up a patient (especially in private hospitals)! But to go on with cardiac diagnostic tools the blood tests can reveal a lot of things; for example a CBC or complete blood count helps detect congestive heart failure. It gives details of cardiac enzymes which are biomarkers – myoblobin, troponin, creatine kinase – which help evaluate extent of damage to heart in post or on going heart attack.
Recently we read about coronary angioplasty procedures which have evolved exponentially, with minimized postoperative risks, simpler procedures and faster recovery time. Check out the “Zaroori Hai” Meril has introduced, calling it an initiative to “ensure what a life-saving difference effective treatments like angioplasties can make, allowing you to enjoy longer and healthier lives.”
Fairly recent is the natriuretic peptides test or “N
T-Pro BNP Serum test” which can detect, diagnose and evaluate severity of congestive heart failure (CHF). BNP is a protein that heart and blood vessels release to help your body eliminate fluids, relax blood vessels and excrete sodium in your urine when there is heart damage. The Troponin (T) test is also for heart attack, troponin a type of protein in blood found when the heart muscle is damaged. Needless to say these blood tests cost, the NT PRO BNP is Rs2,580 at Suburban Diagnostic lab.
Many heart patients who take an interest in their heart matters, now do what is called a homocysteine test (which doctors rarely prescribe routinely for good reasons, some heart doctors do have a warm relationship with their patients and know a homocysteine test is necessary or not, this is also ane expensive blood test). A homocysteine test reveals if you’re lacking in vitamin B6, B12, folic acid which break down homocysteine. If you don’t have enough of Vitamin B6, B12, folic acid in your nutritional profile it makes a difference for elevated homocysteine levels contribute to heart disease, stroke and even eventual dementia. Normal range of homocysteine levels are less than 15 micromoles per liter (mcmol/L). The advice is given to heart patients to go easy on meaty foods and dairy products for excess protein raises homocysteine levels by increasing something called the “methionine burden.” Vegan diets can also result in inadequate vitamin B12 intake and increase homocysteine levels. Sooner than later we must understand that the right food is medicine! The rest is, I suppose, just good-luck and kismet as they say.

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