Brain changes linked to emotion ‘found in people with broken heart syndrome’

Changes in areas of the brain associated with emotion have been identified in people with 'broken heart syndrome', new research has revealed.

Takotsubo syndrome, as it is formally known, is a sudden form of acute heart failure which is estimated to affect as many as 5,000 people in the UK each year and is mainly seen in post-menopausal women.

It can cause the same symptoms as a heart attack, and although the arteries leading to the heart are not blocked, the risk of complications is similar.

While it is not yet fully understood what causes the condition, it is usually brought on by emotional or physical stress such as the loss of a loved one – hence being referred to as broken heart syndrome.

Scientists at the University of Aberdeen, who carried out the research, discovered changes in the level of brain activity in areas known to control the beating of the heart.

In the most detailed study of its kind, they looked at the brains of 25 patients who had suffered an episode of Takotsubo in the previous five days.

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They used brain MRI scans to measure brain volume, surface area and the signals of communication between different areas of the brain.

These results were then compared with control patients who were matched for age, gender and other medical conditions.

Researchers found that there were decreased connections in the thalamus, amygdala, insula and basal ganglia of takotsubo patients compared with healthy people.

These are areas of the brain involved in regulating higher-level functions such as emotions, thinking, language, stress responses and controlling the heart.

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Commenting on the findings, Dr Hilal Khan, clinical research fellow at the university, said: “For years we’ve known that there is a link between the brain and the heart, but the role this plays in takotsubo has been a mystery.

“For the first time we’ve revealed changes in the brain regions that are responsible for controlling the heart and emotions.

“Further work will be required to determine if these changes cause takotsubo syndrome.”

Dr Khan said that with more research it is hoped more effective ways of treating the syndrome can be found.

Carol Duncan, 73, from Aberdeen, is part of the study as she suffered an episode of takotsubo after her brother fell ill and was admitted to ICU.

She said because takotsubo can be triggered by an emotional event, there is a misconception that it is just in your head.

“Knowing that researchers saw measurable changes in my scans makes me feel that we are getting closer to takotsubo being considered a physical condition,” she said.

“It really gives me hope that scientists are moving towards fully understanding and better treating this misunderstood condition.”

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What is broken heart syndrome?

The British Heart Foundation describes takotsubo cardiomyopathy as a “temporary condition where your heart muscle becomes suddenly weakened or stunned. The left ventricle, one of the heart’s chambers, changes shape.”

It can be brought on by a shock. “About three quarters of people diagnosed with takotsubo cardiomyopathy have experienced significant emotional or physical stress prior to becoming unwell,” the charity says. This stress could include bereavement.

As a result of broken heart syndrome, a person may develop an irregular heartbeat, or the heart may become too weak to pump enough blood throughout the body.

Many people simply recover – the stress goes away and the heart returns to its normal shape. But in some extreme cases, the change in the shape of the heart can bring on a heart attack and lead to death.

Some experts believe broken heart syndrome could lead to strokes too. A 2014 study published in the journal JAMA Internal Medicine, found that the death of a partner can increase a person’s risk of suffering a heart attack or a stroke in the following month.

British researchers found that older adults who had lost their partners were about twice as likely to have a heart attack or stroke in the 30 days following their spouse’s death compared with people who had not lost a partner.

Other European studies have also found that mortality rates can increase after the loss of loved ones. The death of a spouse, sibling and a child or indeed of an older child, have all been linked to higher mortality.

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The death of a loved one isn't the only potential cause of broken heart syndrome either, there is some anecdotal evidence heartbreak can be attributed too.

Back in 2018, Helen Ross, 38, from Canterbury, told how she nearly died of a broken heart when it stopped beating twice after she broke up with her childhood sweetheart.

Doctors diagnosed her with stress-induced cardiomyopathy, also known as ‘broken heart syndrome’.

While the condition is usually only seen in elderly people who lose a life partner, in Ross’ case medics suspected it was brought on by the trauma of the break up.

A spokesperson for Cardiomyopathy UK, Dr Daniel Hammersley, said at the time: “The condition causes temporary weakening of the heart muscles which results in the pumping function of the heart.

“It can be associated with events that cause intense stress or emotion in some cases. Patients who develop this condition generally experience symptoms of chest pain or breathlessness.

“Fortunately, in the vast majority of cases the heart muscle function recovers within a few weeks. It is a rare condition overall. It affects women more than men. Most frequently it affects people in their 50s or 60s, although it has been seen in other age groups.”

Additional reporting PA.