Keywords: Broken Heart Syndrome, amygdala, cardiomyopathy, neurotransmitters, cortisol, ventricle, Nigeria.

Introduction.

Dying of a Broken Heart – Nigeria. Is a broken heart syndrome real? How are emotions and the heart connected? Is broken heart syndrome on the rise?  Can you die from a broken heart syndrome?  How to avoid broken heart syndrome.

A 2012 US study found that within the first two years of a child’s death, there was an increased rate of death in the bereaved mother by 133%. Another study from Harvard researchers found that bereaved spouses had upwards of a 66% higher risk of death within three months of their wife or husband’s death.

There are stories in Nigeria about such cases concerning the topic of people dying from a broken heart – Nigeria. Couple married for 72 years die same day, published by Premium Times in 2020. Their children explained that their deaths were expected because of the fondness between them, because they both loved themselves dearly.

Another story told by BBC of February 2022, related the death of a couple who died few months apart. The couple who hailed from Anambra state had just done their traditional marriage and were waiting for their White wedding. Then suddenly, the young man took ill and died. Then 9 months later, the wife died. It is believed that she died of a broken heart.

Stories like these are not new in Nigeria. We all can relate to such, because it had either happened in the family or to others that we know.

Is a broken heart syndrome real?

Broken Heart Syndrome (BHS) is a heart condition. It can be brought about by either psychological or emotional conditions as well as physical conditions. It is called stress induced cardiomyopathy.

 1. Causes and risk factors of broken heart syndrome:

a.  Genetics –

It was originally believed that BHS has no genetic base. But recent studies have shown that BHS can be genetic. Some genes associated with it have been identified.

b. Issues within the brain –

In BHS, there are problems within the brain area called the amygdala. The amygdala controls emotions like fear, etc. It also controls memory, learning, etc. This area is hyperactive in those who will later develop BHS. The meaning is that the problem with the amygdala already exists years before the onset of BHS.

So if a stressor comes in it will increase the activity of the already hyperactive amygdala. The amygdala will then send signals to another area of the brain called the hypothalamus. It does this because the amygdale is sensing fear. So the amygdala wants the hypothalamus to start the process of fight or flight.

When this happens, the hypothalamus will signal the adrenal glands to produce stress hormones such as cortisol, adrenaline and noradrenaline, etc. It is these stress hormones that will cause havoc to the heart. It is called heart brain connection.

c. Other brain hormones affected –

When a person is in love, the neurotransmitter dopamine gets high in the brain and so does the hormone oxytocin. These help to form attachment between the two people. When the relationship suddenly breaks from any reason, these chemicals drop and is replaced by cortisol.

d. Gender and age issues –

BHS can happen to any gender at any age. But it is more with the female gender, especially women above the age of 50 years. This is due to the fact that the level of estrogen in women. Estrogen which actually protects women from heart disease reduces after menopause, thus reducing the protection.      

e. Psychological issues –

The BHS has depressive and anxiety disorders as risk factors. This means that those who suffer from any of these are at a higher risk of BHS.

Grief from any loss, such as the death of a loved one, divorce, loss of home, money, etc. is a risk factor. Relationship issues such as rejection, betrayals etc. are risk factors. Even loss of job or stress from work, especially long term stress, is risk factor.  Working too much without a break can predispose to it. Most of these risk factors are abound in Nigeria.

Any form of bad news can bring it up. Others are fear of speaking in public, witnessing armed robbery or accident, extreme anger, etc. Domestic violence and quarrels with a neighbor can bring it about.

Incidentally, the hearing of good news, surprises, etc. can also be triggers. Unexpected marriage proposals can trigger it. And Psychological stressors are known to predispose women more than men to BHS.      

f. Physical problems –

These include epilepsy, head injuries, infections, certain surgeries, and accidents, etc. May of these factors are quite prevalent in Nigeria.  For men, physical triggers are the most often the risk factors for them.

Symptom presentations:

The symptom is a severe sudden chest pain, making the person believe that he or she is having a heart attack. The pain seems as if the heart is being ripped off.  But BHS is not the same as a heart attack. In heart attacks, or myocardial infarction, there is a partial or complete blocking of the blood vessel to the heart muscle.

The other symptom is shortness of breath. The person feels like he or she is not getting enough air. There is also sweating and dizziness. These symptoms begin within minutes or hours to the stressful event.

But when complications set in, the breathing difficulties worsen due to fluids in lungs. There could be weakness from irregular heartbeats and low blood pressure due to heart failure.

How are emotions and the heart connected?

The brain causes the release of chemicals such as cortisol, adrenaline and nor adrenaline, as documented above. These chemicals affect the contractions of the heart, and can also negatively affect the blood vessels supplying the heart muscles. So the large and small blood vessels supplying the heart muscles with oxygen and nutrients can become narrowed. This narrowing affects only the left ventricle of the heart. Thus this area of the heart muscle may get damaged. For some people, this effect is a temporary thing, but for others, the damage can cause scars to form on the heart muscles.

So the left ventricle of the heart is not able to contract well. This is happening as the other parts of the heart muscles are forcefully contracting. This forces the left ventricle to balloon out at the bottom, with a narrow neck. The function of the left ventricle is to push blood to the rest of the body. Thus because the left ventricle cannot contract well to push out blood to the rest of the body, the blood pressure falls. This also affects the rest of the heart functions and fluids accumulate in the lungs in complicated cases.

1. Can you die of a broken heart syndrome? or Dying from a broken heart – Nigeria:

 Yes, one can actually die from a broken heart. Because when the heart fails, death can occur.  And one does not need to have a previous heart disease to die from a broken heart.  This death occurs in extreme cases.  And those who suffered from diabetes, or smoke, are at increased risk of death from BHS.   This death can occur immediately while the person is still in the hospital, or within 5 years later. Recent research has shown that between 3% to 17% of those who suffer from BHS die within 5 years of the diagnosis.

2. But in majority of cases:

Complications do not set in and the person recovers almost immediately or over days or weeks. And by 6 weeks the person should have recovered. This recovery is most of the time complete recovery. This is because the disruption brought about by the narrowing of the blood vessels to the heart muscles is only temporary.

 Is broken heart syndrome on the rise?       

Yes, research has it that BHS is on the rise globally. Broken heart syndrome has always been there, but only recently been recognized. Even in the Igbo culture, it is recognized. For example, when a man dies and the mother is old in age, she may never be told about the death of her son. This is to prevent her from suddenly dying of grief or dying from a broken heart – Nigeria. And many of such cases were in the past ascribed as a heart attack or other heart conditions by medical science, when it could be BHS.

With modern investigation facilities, the BHS can easily be differentiated from the heart attack. Investigations with the ECG, coronary angiogram, echocardiogram, MRI, etc. can be used to differentiate a BHS from a heart attack.

 How to avoid broken heart syndrome.

This will entail prevention and treatment.

1. Prevention:

It is important to do stress management, practice problem solving skills and good coping skills. These will go a long way to ensuring that one does not overwork oneself. If you have suffered from a relationship breakup, know that it is not the end of the world and that time heals. Get a supportive friend and go out to socialize. Do not spend time alone worrying over it.

Ensure that that you get adequate sleep and proper diet. A regular exercise is very important as well as practicing deep breathing.

Stop smoking or ingesting all substances of abuse. These include cigarette, cannabis, methamphetamine, alcohol, etc.

If the stressors become too much to handle, there is need to consult a psychologist. And if depression or anxiety has set in, consult a psychiatrist.

Make sure that you adhere to your doctor’s advice and medication if you have a medical or physical condition. This includes conditions such as diabetes, hypertension, epilepsy, head injuries, etc.

2. Treatment of Broken Heart Syndrome:

Once BHS has set in, there is need to take the person to the hospital. At the hospital, the person will be interviewed, investigated to rule out or confirm the diagnosis.

Treatments in Nigeria are instituted for the heart condition and any other comorbid illness and complications. The psychologist and the psychiatrists will also be invited. Even after discharge from the hospital, follow up treatments are continued. Treatment will go a long way in preventing dying of a broken heart – Nigeria.

It is important to note that for the very mild cases, the illness will take care of itself. And the person will recover even without treatment.

Having recovered from the first episode, with or without treatment, the condition may not repeat itself. But for a few people, the condition can reoccur.

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