Women with so-called "broken heart syndrome," a rare condition in which the heart muscle is temporarily weakened, have blood vessels that don't respond normally to stress, according to a new study.
The results may explain, at least in part, what causes the condition, as well as help identify women at risk for it, the researchers said.
Broken heart syndrome, also known as apical ballooning syndrome (ABS), occurs almost exclusively in women, usually after they experience an extremely stressful event, such as the loss of a spouse. Patients show a distinctive ballooning of the left ventricle of the heart. Although they experience symptoms similar to those of a heart attack, such as chest pain, patients' arteries have no blockages, as they would in a classic heart attack. And the heart is not permanently damaged — patients usually recover within a few weeks. The exact cause of ABS is not known.
The researchers wanted to learn what it is that makes some women prone to this "broken heart."
The study involved 12 patients who had suffered from ABS in the last six months, 12 women who had never had ABS and four women who had had classic heart attacks.
The researchers gave the participants a series of mental stress tests, and monitored how their blood vessels reacted. For example, the women had to complete memory tests that were increasingly complex, as well as mathematical tasks. Their blood vessel function was measured with devices including a blood pressure arm and finger cuffs.
In the ABS patients, their blood vessels were not working as well as they should have been in response to the stress, said study researcher Dr. Amir Lerman, a cardiologist at the Mayo Clinic in Rochester, Minn. During stress, the blood vessels should have opened wider to allow more blood to flow to the heart. Instead, the blood vessels constricted, diminishing the blood supply to the heart, Lerman said.
The researchers said this abnormal stress response may contribute to ABS.
It's possible that a mental stress test may help pinpoint those who are at risk for the condition, Lerman said.
"Currently, there is no way to identify these women," he said. "We hope that by developing this test, we may be able to identify these patients."
The findings were published online Nov. 23 in the Journal of the American College of Cardiology.
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