Highlights
- •The broken heart syndrome represents a relatively new nosological entity.
- •The broken heart syndrome might trigger cardiac damage and cardiovascular death.
- •The takotsubo syndrome would be a relatively new way of looking at stress-related cardiomyopathy.
Abstract
The cardiac impact of psychological stress historically and socially understood as
boundary experiences of human life has long since become an icon. From the aching
heart to the sudden death provoked by awe, horror, grief, anger, and humiliation on
one side and extreme enchantment, enthusiasm, and excitement on the other, the broken
heart has become a globally recognized and powerful metaphor present from folklore
to popular culture to high literature and back to everyday communication. In medicine,
the “broken heart syndrome” is described as a relatively new nosological entity that
has been used synonymously with the term tako-tsubo or stress cardiomyopathy. Among those three terms, however, the broken heart most
vividly draws the connection between conditions under which lived experience triggers
cardiac damage and conversely, cardiovascular death occurs. According to Hassan and
Yamasaki (2013) [
[1]
] and quite apart from the general perception medical notions of the broken heart indeed
go back to at least 1967, when Rees and Lutkins studied the death rate among 903 relatives
of patients who died in Wales. They found that 4.8% of bereaved close relatives died
within a year of bereavement compared with 0.68% of a non-bereaved control group.
Among widows and widowers, the mortality rate was even 10 times greater than that
of the matched controls. After the first year of bereavement, however, mortality rates
of relatives of a deceased person did not differ significantly from the control group
Rees and Lutkins (1967) [
[2]
]. Similar findings were published by Parkes et al. (1969) [
[3]
] following up on 4486 widowers at the age of 55 for 9 years following the death of their wives in 1957. During the first six months after
the spouse had died, the mortality rate of the widowers was 40% above the rate of
married men of the same age.While it seems plausible to accept the etiological role and pathogenic impact of personal
loss, the pathogenic processes causing death remained relatively blurred. We will
explain, why inaccurately stressing the fact that the broken heart and/or tako-tsubo syndrome would be a relatively new way of looking at stress-related cardiomyopathy
as outlined by Yoshikawa (2015) [
[4]
] and why attaching stress-related cardiomyopathy to culturally powerful yet value-laden
metaphors, might obstruct pathways to a better understanding, prevention and clinical
management of the disease. By looking at narrative understandings and clinical representations
of the broken heart, we aim to highlight the need for a more contextualised view of
the broken heart syndrome in order to facilitate multi- and transdisciplinary approaches
aiming at its prediction, prevention, and treatment.Keywords
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Article info
Publication history
Published online: December 22, 2016
Accepted:
December 16,
2016
Received in revised form:
November 29,
2016
Received:
June 23,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
