At the end of last year U.S. actress Debbie Reynolds died a day after her daughter Carrie Fisher. Many of us are probably aware of bereavement being a risk factor for increased mortality for individuals - often from cardiovascular disease ( heart attacks and strokes ). Years ago an elderly aunt of mine died weeks after the death of her older sister, for whom she had been the main carer.
Major life events such as bereavement do lead to an increased risk of cardiovascular events - usually short-term. A large study involving UK general practices showed 0.16% of the bereaved group had a heart attack or stroke, compared to 0.08% of the nonbereaved controls, within 30 days of their partner’s death. There was also 25% higher mortality in the first year after partner bereavement in older couples, with a peak in the first 3 months.
The absolute contribution of bereavement to overall cardiovascular events is small. It may be an unrepeated event for each individual. There are a variety of possible factors involved, such as short-term changes in blood pressure, heart rate, blood clotting, and chemicals such as cortisol and adrenaline. During the period around the death of a loved one, individuals may neglect their own health needs. Longer-term changes in lifestyle factors, such as smoking and alcohol consumption, may also eventually contribute.
There is an uncommon medical condition sometimes called " broken heart syndrome ", originally recognised in Japan over 25 years ago. It’s known as " stress cardiomyopathy ", or more exotically as " takotsubo/octopus pot cardiomyopathy ". The cardiomyopathies are - literally - conditions with diseased heart muscle, often inherited, not due to coronary artery disease.
Takotsubo cardiomyopathy is acquired, with symptoms like a heart attack, but with no blockage of coronary arteries. It’s commoner in women, and especially occurs following emotional or physical stress such as bereavement. Many people do recover. It’s thought that raised " stress hormones ", such as adrenaline, " stun " the heart, which becomes " ballooned " through failure, and resembles a takotsubo - a pot used by Japanese fishermen to trap octopuses.
This shows - on the left - the heart in a patient with takotsubo, and - right - a ceramic pot used to trap an octopus.
Cardiovascular disease, especially coronary artery disease causing angina and heart attacks, is unfortunately still too common in the U.K., Philippines, and worldwide. Remember there are well known risk factors, numerically more important than the cause(s) of " broken heart ". These may either be " fixed ", such as age and male sex ; or potentially changeable, such as smoking, high blood pressure, diabetes, lack of exercise / obesity, alcohol excess, and high blood lipid levels .
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