independent

Thursday 17 April 2014

How the loss of a loved one can put your own life on the line

Ever heard the phrase, 'he died of a broken heart' and dismissed it as a figure of speech? It's time to think again, says Amy Vickers

They lived happily married for 55 years. The day after he died, she suffered a stroke, followed by a heart attack, and then she joined him. "She died of a broken heart" said their daughter, model Christie Brinkley, trying to explain how someone who had earned the nickname 'Miracle Marge' after surviving eight strokes, three heart attacks and two major brain surgeries, had lost her fight for life.

The recent obituary of Marjorie Brinkley read: "Her heart never survived losing the love of her life."

Broken heart syndrome is the medically accepted term to explain the strain put on the organ after the death of a loved one.

A 'perfect storm' of stress, lack of sleep and forgetting to take regular medication puts mourners at increased risk in the days and weeks after bereavement.

Studies show that severe emotional distress, such as the kind that is experienced after a the death of a loved one, can bring on heart failure or heart-attack-like symptoms.

The condition usually resolves within weeks, with no lasting damage – but in rare cases, particularly if there is a pre-existing medical condition, it can prove fatal.

Contrary to popular belief, women are up to nine times more likely to suffer from the condition than men, a 2011 study analysing more than 10,000 people across the US found.

The findings, reported to the American Heart Association showed that those older than 55 were 4.6 times more likely to develop the condition than younger women and scarily, in about one in three cases, the syndrome is serious enough to kill.

"The new finding from this large sample is that there is such a sharp divide at the age of 55 for women," says Dr Abhishek Deshmukh, who conducted the study at the University of Arkansas.

"One theory is that hormones play a role. Men may be able to handle stress better because they have more adrenaline receptors in their hearts than women do."

Dr Angie Brown, medical director of the Irish Heart Foundation said: "We're not 100pc sure what causes stress-induced cardio-myopathy – also known as broken-heart syndrome – but it seems to be that the stress stimulates the release of hormones such as adrenaline and nor-adrenaline, the effect of which is to deprive the left ventricle (the heart's pumping mechanism) of oxygen and cause a sudden temporary weakening of the heart muscle.

This stuns the heart and it can't work properly.

"It appears to be more commonly seen in post-menopausal women. Often, there is a history of a recent severe emotional or physical stress.

"When it happens, the symptoms can include chest pain and shortness of breath, so patients are treated for a heart attack until it is proven otherwise."

Some experts say that after being with someone for such a long period of time, especially after sleeping next to each other, one person's heartbeat can affect and regulate another's.

The sudden onset of grief can also weaken the heart muscle, spike blood pressure, cause fluid in the lungs and weaken immunity, which explains why people with medical conditions such as cancer can also be affected.

A study earlier in 2012 by immunity experts at the University of Birmingham found biological evidence to suggest that bereavement lowers the immune system, putting sufferers at the mercy of life-threatening infections.

The researchers found that this kind of emotional stress causes a drop in the efficiency of white blood cells that are needed to fight cancer and pneumonia, which is a major cause of death in older adults.

TO stand back powerless and watch two parents depart within a short space of each other is almost too much to bear, but perhaps there is some comfort to be found in their parents being reunited. Brenda Ryan* lost her parents within a month of each other.

"We've always believed Mum died of a broken heart, if there is a possibility," she says. "They were both diagnosed with terminal cancer in September 2004.

We were never told they had a certain amount of time to live (we didn't want to know anyway) but that their cancers could be controlled by chemo. Dad's chemo never worked and he died the following January.

"However, Mum's worked and her doctors were amazed at how much her tumours had shrunk. She was concentrating on getting her life back together, but all along she could see my father – it used to freak me out sometimes!

"She had to constantly go back to hospital to get fluid drained from her lungs – it was on one such visit that she took a turn and just passed away quickly.

"We believe Dad was calling her away from her hardship."

Another real-life example is that of the actors Martin and Gary Kemp, whose parents died within 48 hours of each other, both of heart conditions.

Their father Frank, a 79-year-old former printer, suffered a fatal heart attack whilst his wife Eileen, 77, was having having a heart-bypass operation in hospital.

When she came round, the sons broke the tragic news, only to leave her inconsolable at the loss of her husband of 55 years and unable to fight for her own life. The shock and the grief were said to have destroyed any chances of her hoped-for recovery.

Simon Monjack, who was married to the actress Brittany Murphy (both pictured right), died from heart complications only five months after his wife passed away suddenly at only 32. He was 39.

It used to be thought that heartbreak was an emotional state but after a ground-breaking study in 2005 from Johns Hopkins, at the University School of Medicine in the US, scientists began to fully understand the heart and what stress does to it.

Suddenly new studies showed that it harms people physically.

Dr Ilan Wittstein, from Johns Hopkins, who coined the term 'broken heart syndrome', found that the adrenaline from extreme fear, anxiety and even surprise was able to paralyse a heart, so that it couldn't squeeze normally and blood flow was reduced.

He said people mourning a close relative are 21 times more likely to suffer a heart attack themselves.

"It can be very serious," explains Wittstein. "The heart is a pump and if that pump is suddenly stunned and can't pump, than the whole body isn't getting the blood flow that it needs. Anyone under stress is vulnerable."

Stress can mean that people don't function to their normal ability. Mourners can forget to take their regular medications, they might drink more alcohol and they might eat junk food.

Doctors advise that close relatives, friends and carers should rally round and make sure that the bereaved are taking regular medication and are looking after themselves – especially near the beginning of the grieving process. The way people cope with grief also has a critical effect on their health.

Those who suppress their pain, rather than unburdening their feelings and allowing the tears to flow, are more likely to experience a physical breakdown, which allows disease in through a back door. So what can we do to prevent broken heart syndrome?

Dr Angie Brown, from the Irish Heart Foundation, says: "It is difficult for any of us to avoid these types of stressful situations and therefore to avoid broken heart syndrome. However it's important to have a healthy lifestyle with a good diet and regular exercise, don't smoke, get your blood pressure and cholesterol checked and treated if possible.

"The fitter and healthier we are, the easier it is to deal with stress and illness. If you do develop significant chest pain or significant breathlessness, then call 999 and seek urgent medical attention, so this syndrome or other causes of chest pain such as a heart attack due to a blocked artery can be treated rapidly. Prompt action may save your life."

For more information see www.irishheart.ie, or if you would like to talk to an Irish Heart Foundation nurse in confidence, call 1890 432 787, Monday to Friday, 10am to 5pm.

* Name has been changed

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