Research associates COVID-19 with spike in broken heart syndrome

Research associates COVID-19 with spike in broken heart syndrome
A recent study talks about the relationship between the COVID-19 pandemic and stress cardiomyopathy, a condition people often call broken heart syndrome. Not expectedly, the researchers discovered an uptick in the amount of cases.

Scientists are slowly unraveling the entire impact of COVID-19 on physical health. However, the impact of the pandemic on mental health is merely now getting into focus. A recently available study assesses the incidence of a health condition that doctors relate with mental stress.

Stress cardiomyopathy, which can be called Takotsubo cardiomyopathy and broken heart syndrome, occurs in response to physical or emotional stress.

The author of a youthful study describes it as “a condition caused by strong emotional or physical stress leading to rapid and extreme reversible cardiac dysfunction.”

Individuals who experience stress cardiomyopathy display similar symptoms to a coronary attack, including chest pain and shortness of breath. Unlike a coronary attack, however, there is nothing blocking the coronary arteries.

Although scientists do not know the specific mechanisms that drive stress cardiomyopathy, some assume that stress hormones might interfere with the heart’s capability to pump blood sufficiently.

A new study, which appears in JAMA Network Open, asks if the psychological, social, and financial stress of the pandemic comes with an association with an elevated incidence of stress cardiomyopathy.

Stress, anxiety, and COVID-19
As the authors explain in their paper, “The result of COVID-19 has extended beyond healthcare, having significant social, economic, and cultural ramifications. The global ramifications of the virus have been linked with increasing anxiety and stress worldwide.”

Study lead Dr. Ankur Kalra explains how these stresses “can have physical effects on our bodies and our hearts, as evidenced by the increasing diagnoses of stress cardiomyopathy we are experiencing.”

The authors of the existing study set out to quantify the upsurge in incidence.

They also wished to investigate whether psychological, social, and monetary stress could clarify the increase, or whether SARS-CoV-2 - the virus that triggers COVID-19 - might prompt a condition that resembles stress cardiomyopathy.

To research, the researchers delved into retrospective medical records. They identified individuals who attained a healthcare facility with symptoms of acute coronary syndrome (ACS).

ACS is an umbrella term for scenarios where the heart muscle receives a lower blood supply from the coronary arteries. ACS includes coronary attack and unstable angina.

They took patient data from March-April, 2018, January-February 2019, March-April 2019, and January-February 2020, which was a control group. They compared this with data from March-April 2020. All patients received treatment in two hospitals in Ohio, in the usa.

Altogether, the hospitals treated 1,914 those who offered ACS symptoms. Of the, 1,656 cases occurred prior to the pandemic, and 258 during the pandemic. Importantly, all people with ACS who were in a healthcare facility during the pandemic tested negative for SARS-CoV-2.

Upsurge in ‘broken heart syndrome’
During their analysis, the authors found “a substantial increase in the incidence of stress cardiomyopathy in patients presenting with ACS through the COVID-19 period.”

In the pre-COVID samples, stress cardiomyopathy accounted for 1.5%-1.8% of patients, however in the March-April 2020 group, doctors registered stress cardiomyopathy in 7.8% of patients.

Although there have been no distinctions between mortality rates, the researchers noted that folks with stress cardiomyopathy through the pandemic had drastically longer hospital stays than those prior to the pandemic.

Because none of the individuals in the analysis group had COVID-19, the authors believe this supports the idea that the psychological stress of living through a pandemic escalates the threat of stress cardiomyopathy.

The authors outline certain limitations with their study. Firstly, the study only included individuals from Northeast Ohio, and therefore, may not represent other regions or countries. Secondly, it's possible that some patients avoided visiting a healthcare facility during a pandemic, for example, those with less extreme symptoms.

Thirdly, the authors describe that the COVID-19 tests the analysis used had a sensitivity rate of 79%. This implies that a number of the participants may have had COVID-19.

However, the authors make clear that “none of the patients identified as having stress cardiomyopathy in the study group reported any observeable symptoms suggestive of COVID-19-related illness.”

Mental health insurance and stress cardiomyopathy
An earlier study found that, compared with people with ACS, individuals with stress cardiomyopathy were twice as more likely to have neurologic or psychiatric disorders.

Of the 1,750 persons the analysis enrolled, 42.3% had a diagnosed psychiatric illness, and of these, half were affective disorders, such as depression and bipolar disorder.

Although the bond between psychiatric conditions and stress cardiomyopathy is fairly more developed, until scientists carry out more studies, the specific nature of the partnership is unclear.

As societies battle a pandemic, global mental health is facing significant challenges. Senior author Grant Reed explains:

“As the pandemic continues to evolve, self-care during this difficult time is crucial to our heart health, and our overall health. For those who feel overwhelmed by stress, it’s important to reach out to your doctor. Exercise, meditation, and connecting with friends and family, while maintaining physical distance and safety measures, can also help relieve anxiety.”
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