Healthy Grieving for Pets by Maria Dorfner

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I have always known that pets have souls.  Artist, Boris Jairala knows it too.  If you listen with your heart, you can actually hear what pets are trying to say to you.  Think about how you would communicate if you could not speak.  Your eyes or body language would need to reflect all your emotions: happiness, sadness, love, anger.

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I believe when you are close to a pet they can intuit how you feel and they respond in kind.

It’s reassuring to be comforted this way. And they love unconditionally.

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Numerous health studies validate the healthy therapeutic affects of living with pets.
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Pets do not care what you look like and treat you the same if you’re wearing sweat pants or a ball gown.  They do not criticize you.  They do not cheat, lie or steal (well, maybe a few socks that mysteriously vanish) or care about your weight, height or job title.  They ask no questions.  They merely accept you and love you for being alive.  Refreshing.
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It’s no wonder people with pets live longer. According to the Centers for Disease Control (CDC), pet ownership not only decreases blood pressure, but your cholesterol levels, and
triglyceride levels.  The American Veterinary Medical Association, The National Institutes of Health (NIH) and The Delta Society agree.
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According to WebMD, there are 27 more health benefits, including lifting depression, being a natural mood enhancer, helping those with ADHD release excess energy, lowering the risk of dying from cardiac disease, increasing survival rates after a heart attack or stroke while boosting your immune system, plus more.
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Some dogs can even alert diabetic owners of a drop in their blood glucose. There are also super sensitive dogs, like empaths.  They sense when you’re not feeling well.  Their calming presence helps create emotional balance in owners.  One look or touch can tell you they know how you feel, and will stand by you.
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It’s a rare kind of unconditional love in a world that creates laws for things that should come naturally –kindness, respect and not judging others based on skin color, race or anything else, so long it’s not harming another individual.  Kids learn responsibility from having to walk and feed the pet, and you are guaranteed your thirty minutes of walking each day, which helps keep them or you fit, and lower risks for all sorts of diseases.
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So, what happens when a pet dies and you lose all that?  How do you deal with the grief that comes from the death of such a loving pet?

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I recall reading Elsabeth Kubler-Ross’s book, “On Death and Dying.” It was published in 1969.  A friend gave it to me after my grandmother passed away.  Prior to that, no one I knew personally had ever died.  It was something that happened to other people.  The book helped me process my feelings at the time. It wasn’t only my own feelings.  I was also absorbing the grief from my parents, aunts, uncles, cousins, siblings, neighbors and everyone around me.  Overwhelming.  “On Death and Dying” outlines the 5 stages of grief.

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People go through the 5 different stages for a person or pet at their own pace.  It can also happen when someone is diagnosed with a terminal illness or from divorce or a breakup. The stages don’t happen the same way for each person. Each individual needs to take as much time as they need to process it.  When death is sudden and unexpected and you can’t get beyond anger is when it’s best to seek out professional help.
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NATURAL STAGES OF GRIEF AFTER LOSS:

1. Denial and Isolation

The first reaction that buffers the immediate shock.  You feel no pain.
2. Anger
Reality kicks in.  Emotions are in overdrive.  This is when you snap at things and then feel guilty or more angry for doing so.
3. Bargaining
You try to regain control by telling yourself, “If only I had…” because you feel vulnerable and helpless.
You feel overwhelming sadness, regret and worry.
5. Acceptance
 After you allow yourself to grieve naturally, you will heal.
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These 5 stages are the same for the loss of people or pets.
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Boris Jairala learned this when his father died, then his dog.
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No one wants to forget a pet or person they love. Painting helped Boris cope with loss. Gretchen Rubin, author of “Happier at Home” wrote, “Capturing a moment in time isn’t just about securing a memory –it can help you appreciate your life every day.”  She adds, “Photos are a way to record life’s little moments that are precious but easily forgotten.”
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The unique frames hold ashes in the front, and memorable keepsake items in the back.
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Painting a memorial of his father inspired him to do the same for his dog.
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When friends saw it, they loved it and asked Boris if he could create one for them.
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Each frame can be customized to match the interior design of a home.  Boris adds, “If you already have an audio recording of your pet that can also be added. For people you love, I can add a special recording of their voice or a special song.   A woman who lost a child that was premature asked me to create a special frame, and it was very touching.  I’m deeply moved by the joy it brings.”
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They say two things are certain in life, death and taxes.  This won’t help with taxes, but it’s a unique way to help with the first. Rubin says positive memories and photographs play an important role in a happy life.
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Boris is from Brooklyn, NY and works out of a studio there.  His dream is to open a workshop.  His Kickstarter campaign launches soon.

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He says, “My dream with HERE AFTER FRAMES and the upcoming Kickstarter campaign is to raise enough to make this available to everyone in the world.”
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He has a patent and is the only person in the world creating such an item.
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UPDATE:
 Boris met his Kickstarter campaign goal (thank you to anyone who contributed), but you can still view or order the keepsakes as a gift or for yourself and have them customized here:  http://www.HereAfterFrames.com
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MORE ARTICLES TO HELP YOU THROUGH THE GRIEVING PROCESS HERE:

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Maria Dorfner is the founder of Healthy Within Network. This is her blog.

Stay healthy!

Coping with Grief

Dealing With the Loss of a Loved One

Events like anniversaries or holidays can sometimes prolong or reintroduce grief.

Just after a death or loss, you may feel empty and numb, as if you are in shock. You may notice physical symptoms such as trembling, nausea, difficulty breathing, muscle weakness, dry mouth, or trouble sleeping and eating. You may become angry at a situation, a particular person, or just angry in general. Almost everyone experiencing grief also feels guilt. Guilt is often expressed in statements that begin with “I could have,” “I should have,” and “I wish I would have.” People who are grieving may also have strange dreams or nightmares, be absentminded, withdraw socially, or lack the desire to return to work. While these feelings and behaviors are normal during grief, they will pass.

Grief lasts as long as it takes you to accept and learn to live with your loss. For some people, grief lasts a few months. For others, grieving may take years. Sometimes an anniversary or special holiday, such as Valentine’s Day, may trigger feelings of grief. The length of time spent grieving is different for each person. There are many reasons for the differences, including personality, health, coping style, culture, family background, and life experiences. The time spent grieving also depends on your relationship with the person lost and how prepared you were for the loss.

Every person who experiences a death or other loss must complete a four-step grieving process:

  • Accept the loss
  • Work through and feel the physical and emotional pain of grief
  • Adjust to living in a world without the person or item lost
  • Move on with life

The grieving process is complete when a person completes these important steps.

Just after a death or loss, you may feel empty and numb, as if you are in shock. You may notice physical symptoms such as trembling, nausea, difficulty breathing, muscle weakness, dry mouth, or trouble sleeping and eating. You may become angry at a situation, a particular person, or just angry in general. Almost everyone experiencing grief also feels guilt. Guilt is often expressed in statements that begin with “I could have,” “I should have,” and “I wish I would have.” People who are grieving may also have strange dreams or nightmares, be absentminded, withdraw socially, or lack the desire to return to work. While these feelings and behaviors are normal during grief, they will pass.

Grief lasts as long as it takes you to accept and learn to live with your loss. For some people, grief lasts a few months. For others, grieving may take years. Sometimes an anniversary or special holiday, such as Valentine’s Day, may trigger feelings of grief. The length of time spent grieving is different for each person. There are many reasons for the differences, including personality, health, coping style, culture, family background, and life experiences. The time spent grieving also depends on your relationship with the person lost and how prepared you were for the loss.

Every person who experiences a death or other loss must complete a four-step grieving process:

  • Accept the loss
  • Work through and feel the physical and emotional pain of grief
  • Adjust to living in a world without the person or item lost
  • Move on with life

The grieving process is complete when a person completes these important steps.

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Coping with Grief: How to Handle Your Emotions

Traumatic events are a shock to the mind and body, and lead to a variety of emotions. Coping with grief takes time, help from others, and the knowledge that grieving isn’t easy.

Medically reviewed by Lindsey Marcellin, MD, MPH
Grief is an emotion that takes time to deal with, but you can get through it and eventually move on. Grieving is a healthy response to tragedy, loss, and sadness, and it’s important to allow yourself time to process your loss.

Coping With Grief: The Range of Emotions

Grief doesn’t just happen after someone dies. Any traumatic event, major life change, or significant loss — a rape, a divorce, even major financial losses — can cause grief. Throughout the grieving process, you may find yourself feeling:

Coping With Grief: Accepting It

“Don’t try to run away from it; rather, face it head on,” advises Sally R. Connolly, a social worker and therapist at the Couples Clinic of Louisville in Louisville, Ky. In more than 30 years of practice, Connolly has helped many individuals and couples deal with grief and various traumatic events.

“Acknowledge that something traumatic has happened and that it has had a profound effect on you,” Connolly advises. Give yourself time to grieve, but seek help when you need it.

Coping With Grief: Finding Help

You may want some time alone to process your thoughts and struggle with your grief, but it’s important to recognize when you need help from others.

“You might need more help if you find that, after some time, you are not able to get back to normal activities, you have trouble sleeping or eating, or have thoughts and feelings that interfere with everyday life,” says Connolly.

A grief counselor or other therapist may be able to help you cope with grief, and finally start to move past it. Getting your grief out in the open is an important first step.

“Talk about it with someone — a friend, family, a support group. Support groups can be wonderful,” Connolly says. There, you can relate to other people who understand your situation, and you can get advice on what helped them through their grief.

Of course, expressing your emotions doesn’t have to be done out loud. “Write about it,” suggests Connolly. Rather than allowing thoughts to swirl in your head, put them down on paper. This is a great way of getting out your feelings if you are shy or embarrassed about sharing them with another person.

Coping With Grief: Getting Closure

Closure is also an important part of coping with grief and may help you move through the grieving process.

“Depending on the event, developing a ritual to say farewell may be helpful. We have funerals when someone dies and they are a healthy step on the road to acceptance. Rituals can be helpful for other traumas as well,” Connolly says.

Coping With Grief: When Will I Feel Better?

There is no set timeline for grieving. And unfortunately, you may never completely get over your loss. But your loss shouldn’t keep you from enjoying life, even with occasional periods of sadness.

“Let yourself grieve as long as you need to. You do have to resume normal life, but know that it’s going to take a while,” says Connolly.

Look for small signs that you’re coping with grief and getting past it. “Happy times signal that you’re progressing,” she says. When you realize that you aren’t always dwelling on the sadness or don’t think about it as frequently as you once did, that means that you’re finally moving on — at your own pace.

Your mind and body need time to grieve after a traumatic event. If you deprive yourself of the grieving process, you may find that you have more difficulty accepting what has happened or that unresolved feelings and issues may flare up later on. Allow yourself to feel sad and even selfish; eventually you’ll find yourself feeling better a little bit at a time. Even though part of you may always feel sad about your loss, you’ll find yourself happy and laughing again one day.

[Source: http://www.everydayhealth.com]

Related Articles

 
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According to the American Academy of Family Physicians (AAFP), emotionally healthy individuals have a capacity to process and express their emotional experiences in a productive way that reduces stress. Many life transitions, both positive and negative, can produce a sense of loss, sadness and anger. Acknowledging sadness and seeking support through difficult times can be critical to stress management and physical health.

Emotional Health

Experts at the American Academy of Family Physicians note that emotional health is defined by how people handle difficult emotions. For example, many of life’s challenges, such as the loss of a job or death of a family member, can leave us with a marked sense of sadness and even anger. Doctors note that the expression of these feelings is critical to maintaining stability both physically and emotionally. When we feel sad it important to express those feelings to others in appropriate ways or use activities such as meditation or exercise to release the built-up stress.

The Mind/Body Connection

According to the American Academy of Family Physicians, our bodies react to the way we feel. If we are sad or stressed about a situation, our bodies might respond with a variety of physical systems, such as headaches, difficulty sleeping, and weight loss or weight gain. When we monitor our emotions and identify how we feel, we can choose effective tools to care for our health. When people do not acknowledge and work through emotions such as sadness, they can often develop unhealthy coping mechanisms, such as overeating or substance abuse to avoid the difficult feelings or to find a sense of comfort.

Coping with Sadness

Dr. Edward T. Creagan of the Mayo Clinic suggests that people take particular care of their health in the aftermath of a sad or upsetting event. Eating a healthy diet, maintaining a healthy sleep schedule, and talking to trusted friends or a counselor are all helpful tools for coping with sadness. When people use these methods for self-care, they often find that the period of sadness passes within a reasonable amount of time.

Sadness and Depression

When sadness is not expressed or processed in healthy ways, it often can lead to depression. The American Academy of Family Physicians notes that this is particularly common among people who use alcohol or drugs to cope with sad feelings. Many of these substances depress the central nervous system and leave the individual feeling increasingly more depressed. People having a particularly difficult time with persistent feelings of sadness should consider consulting a medical professional or therapist for additional support.

Treatment for Emotional Issues

People who struggle with healthy management of emotions often find that they benefit from counseling or support groups. Doctors at the American Academy of Family Physicians note that sadness, when not processed and communicated, can lead to destructive emotional patterns, such as anger management issues. By working with professional counselors or peer support groups, people can learn to identify how they feel and how to cope in healthy ways.

References

Read more: http://www.livestrong.com/article/180006-how-is-sadness-healthy/#ixzz1rC1fjlcD

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Is Crying Healthy?

When emotions overtake you, crying can be a healthy emotional release. But not all environments are conducive to alleviating sadness or expressing relief.

Medically reviewed by Pat F. Bass III, MD, MPH

The notion that big boys or big girls don’t cry is a persistent idea fed by popular sayings, but psychologists and researchers say that it’s just not so. Shedding tears can be a huge and very healthy emotional release, particularly if you are experiencing deep pain, sadness, anger, or stress.

One study analyzed 140 years of popular articles about crying and found that more than 9 in 10 found tears to be a good way to release pent-up feelings. An international sample of men and women from 30 countries found that most reported feeling relief after a good cry. And about 70 percent of therapists say they believe crying is good for their patients.

Crying as Catharsis

The main benefit of crying is catharsis, or a purging or purification of your feelings through emotional release. When you cry, you can let go of the tension and sadness and other emotions that have been causing you pain. In many ways, crying serves as a safety valve that allows you to blow off emotions that have built up too much pressure inside you.

It’s been difficult for researchers to figure out how this works. When tears are induced in a laboratory setting — for example, having subjects watch a sad movie — more often than not the participants report that they feel worse rather than better.

Despite this, people consistently report that a good cry makes them feel better. One recent study reviewing more than 3,000 detailed reports of recent crying episodes found that most people reported an improvement in their mood afterward. Another study of 196 Dutch women found that nearly 9 in 10 said they felt better after crying.

Another benefit of crying is that it can bring people closer. An Israeli researcher studying the evolutionary aspects of crying has speculated that shedding tears communicates vulnerability to others, since the tears blur your vision and leaves you defenseless. A person who cares for you while you are in this weakened state can grow closer to you, and the bond between the two of you may grow stronger.

Have a Healthy Cry

Research has found that for crying to improve emotional health, certain conditions need to be met:

  • You should have a shoulder to cry on. People who receive social support while crying report more cathartic release than people who cry alone. Find a friend or loved one you trust.
  • You should cry after you’ve solved the problem. People feel better when they cry about a problem that’s already been resolved. If you cry before you’ve dealt with the situation that’s making you feel like crying, you are likely to receive no benefit or actually make yourself feel worse rather than better.
  • You need to make sure you’re crying in an appropriate place. People who experience shame or embarrassment while they cry are less likely to report an improvement of their mood. If you’re going to feel bad about crying in a public place or in front of certain people, you need to hold back your tears and go somewhere else.
  • Crying likely won’t help you if you are living with a mood disorder. People who live with clinical depression or anxiety disorders are less likely to feel better after they have a good cry. If you find yourself feeling worse after crying, you should see a doctor or therapist to see if you have a mood disorder.

But if you can’t stop the tears from falling, go ahead and let it all out — the odds are you’ll feel better afterward.

Broken Heart Syndrome Real and May Be Deadly


“Broken Heart Syndrome.  BHS.  When someone else’s B-S affects your Heart, you get BHS. Other times, grief from the death of a loved one can trigger it.  Symptoms of BHS can mimic a heart attack.  Severe, but reversible.  Your heart may take up to two weeks to recover from BHS.  A reminder that your heart is precious and linked to your overall health and well-being.”  ~Maria Dorfner

BROKEN HEART” SYNDROME: REAL, POTENTIALLY DEADLY BUT RECOVERY QUICK

— Hopkins scientists discover that emotional shock can trigger sudden, reversible heart failure that is not a classic heart attack

Hopkins cardiologist Ilan Wittstein, M.D.*click on image for higher resolution version

Shocking news, such as learning of the unexpected death of a loved one, has been known to cause catastrophic events, such as a heart attack.

Researchers at Johns Hopkins have discovered that sudden emotional stress can also result in severe but reversible heart muscle weakness that mimics a classic heart attack.  Patients with this condition, called stress cardiomyopathy but known colloquially as “broken heart” syndrome, are often misdiagnosed with a massive heart attack when, indeed, they have suffered from a days-long surge in adrenalin (epinephrine) and other stress hormones that temporarily “stun” the heart.

“Our study should help physicians distinguish between stress cardiomyopathy and heart attacks,” says study lead author and cardiologist Ilan Wittstein, M.D., an assistant professor at The Johns Hopkins University School of Medicine and its Heart Institute.  “And it should also reassure patients that they have not had permanent heart damage.”

In the Hopkins study, published in The New England Journal of Medicine, the research team found that some people may respond to sudden, overwhelming emotional stress by releasing large amounts of catecholamines (notably adrenalin and noradrenalin, also called epinephrine and norepinephrine) into the blood stream, along with their breakdown products and small proteins produced by an excited nervous system.  These chemicals can be temporarily toxic to the heart, effectively stunning the muscle and producing symptoms similar to a typical heart attack, including chest pain, fluid in the lungs, shortness of breath and heart failure.

Upon closer examination, though, the researchers determined that cases of stress cardiomyopathy were clinically very different from a typical heart attack.

“After observing several cases of ‘broken heart’ syndrome at Hopkins hospitals – most of them in middle-aged or elderly women – we realized that these patients had clinical features quite different from typical cases of heart attack, and that something very different was happening,” says Wittstein.  “These cases were, initially, difficult to explain because most of the patients were previously healthy and had few risk factors for heart disease.”

For example, examination by angiogram showed no blockages in the arteries supplying the heart.  Blood tests also failed to reveal some typical signs of a heart attack, such as highly elevated levels of cardiac enzymes that are released into the blood stream from damaged heart muscle.  Magnetic resonance imaging (MRI) scans confirmed that none of the stressed patients had suffered irreversible muscle damage.  Of greatest surprise, the team says, was that recovery rates were much faster than typically seen after a heart attack.  Stressed patients showed dramatic improvement in their hearts’ ability to pump within a few days and had complete recovery within two weeks.  In contrast, partial recovery after a heart attack can take weeks or months and, frequently, the heart muscle damage is permanent.

The researchers collected detailed histories and conducted several tests, including blood work, echocardiograms, electrocardiograms, coronary angiograms, MRI scans and heart biopsies, on a total of 19 patients who came to Hopkins between November 1999 and September 2003.  All had signs of an apparent heart attack immediately after some kind of sudden emotional stress, including news of a death, shock from a surprise party, fear of public speaking, armed robbery, a court appearance and a car accident.  Eighteen of the stressed patients were female, between the age of 27 and 87, with a median age of 63.  The results were then compared to seven other patients, all of whom had suffered classic, severe cases of heart attack, called a Killip class III myocardial infarction.

When results from both groups were compared, the researchers found that initial levels of catecholamines in the stress cardiomyopathy patients were two to three times the levels among patients with classic heart attack, and seven to 34 times normal levels.

  • Catecholamine metabolites, such as metanephrine and normetanephrine, were also massively elevated, as were other stress-related proteins, such as neuropeptide Y, brain natriuretic peptide and serotonin.  These results provided added confirmation that the syndrome was stress induced.  Heart biopsies also showed an injury pattern consistent with a high catecholamine state and not heart attack.

A hallmark feature of the syndrome was the heart’s unique contraction pattern as viewed by echocardiogram, or ultrasound.  While the base of the heart’s main pumping chamber, the left ventricle, contracted normally, there was weakened contraction in the middle and upper portions of the muscle.  Other characteristics included a distinctive pattern on electrocardiogram, or EKG.

“How stress hormones act to stun the heart remains unknown, but there are several possible explanations that will be the subject of additional studies,” says study co-investigator and cardiologist Hunter Champion, M.D., Ph.D., an assistant professor at Hopkins and its Heart Institute.  “The chemicals may cause spasm in the coronary arteries, or have a direct toxic effect on the heart muscle, or cause calcium overload that results in temporary dysfunction.”

The researchers also plan to study whether certain patients have a specific genetic vulnerability for developing stress cardiomyopathy, and why it predominantly strikes older women.

While the folklore of “broken heart” syndrome has been around for decades, the prevalence of the condition remains unknown.  According to Wittstein, some reports exist, mainly from Japan, and describe similar syndromes, but no biochemical analyses have previously been performed that link the condition to elevated catecholamine levels.  The researchers contend that while stress cardiomyopathy is not as common as a typical heart attack, it likely occurs more frequently than doctors realize.  They expect its numbers to increase as more physicians learn to recognize the syndrome’s unique clinical features.

Funding for this study, conducted solely at Johns Hopkins, was provided by the Bernard A. and Rebecca S. Bernard Foundation.  Other researchers who took part in this study were Trinity Bivalacqua, M.D., Ph.D.; Jeffrey Rade, M.D.; Katherine Wu, M.D.; Gary Gerstenblith, M.D.; Steven Schulman, M.D.; Kenneth Baughman, M.D.; João Lima, M.D.; and David Thiemann, M.D.

GRIEF AND THE BROKEN HEART:

http://www.freep.com/article/20120110/FEATURES01/201100309/Broken-heart-isn-t-just-fiction

More on Broken Heart Syndrome from MAYO CLINIC

By Mayo Clinic staff


Original Article:  http://www.mayoclinic.com/health/broken-heart-syndrome/DS01135


Definition

Broken heart syndrome is a temporary heart condition brought on by stressful situations, such as the death of a loved one. People with broken heart syndrome may have sudden chest pain or think they’re having a heart attack. These broken heart syndrome symptoms may be brought on by the heart’s reaction to a surge of stress hormones. In broken heart syndrome, a part of your heart temporarily enlarges and doesn’t pump well, while the remainder of the heart functions normally or with even more forceful contractions.

The condition was originally called takotsubo cardiomyopathy. Today, it’s also referred to as stress cardiomyopathy, stress-induced cardiomyopathy or apical ballooning syndrome.

The symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in about a week.

Symptoms

Broken heart syndrome symptoms can mimic a heart attack. Common symptoms include:

  • Chest pain
  • Shortness of breath
  • An irregular heartbeat
  • A generalized weakness

Any long-lasting or persistent chest pain could be a sign of a heart attack, so it’s important to take it seriously and call 911 if you experience chest pain.

When to see a doctor
If you’re having any chest pain, a very rapid or irregular heartbeat, or shortness of breath after a stressful event, call 911 or emergency medical assistance immediately.

Causes

The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn’t completely clear. A temporary constriction of the large or small arteries of the heart may play a role.

Broken heart syndrome is often preceded by an intense physical or emotional event. Some potential triggers of broken heart syndrome are:

  • News of an unexpected death of a loved one
  • A frightening medical diagnosis
  • Domestic abuse
  • Losing a lot of money
  • A surprise party
  • Having to perform publicly
  • Physical stressors, such as an asthma attack, infection, a car accident or major surgery

How is broken heart syndrome different from a heart attack?
Most heart attacks are caused by a complete or near complete blockage of a heart artery. This blockage is due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis) in the wall of the artery. In broken heart syndrome, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.

Risk factors

Broken heart syndrome affects women far more often than men. It appears that most people who have broken heart syndrome are women 50 or older.

Complications

In rare cases, broken heart syndrome is fatal. However, most who experience broken heart syndrome quickly recover and don’t have long-lasting effects.

Other complications of broken heart syndrome include:

  • Disruptions in your heartbeat
  • A fast or slow heartbeat
  • Backup of fluid into your lungs (pulmonary edema)

It’s also possible that you may have broken heart syndrome again if you have another stressful event.

Preparing for your appointment

Broken heart syndrome is almost always diagnosed in an emergency or hospital setting, since most people with the condition have symptoms identical to a heart attack.

Call 911 or emergency medical help or have someone drive you to an emergency room if you experience new or unexplained chest pain or pressure that lasts for more than a few moments. Don’t waste any time for fear of embarrassment if it’s not a heart attack. Even if there’s another cause for your chest pain, you need to be seen right away.

Have a family member or friend come with you, if possible. Someone who accompanies you can help soak up all the information provided during your evaluation.

Share this information on the way to the hospital:

  • Any symptoms you’re experiencing, and how long you’ve had them.
  • Your key personal information, including any major stresses, such as the death of a loved one, or recent life changes, such as the loss of a job.
  • Your personal and family medical history, including other health problems that you or your close relatives have had, such as diabetes, high cholesterol or heart disease. It’s also helpful for your doctor to know about any prescription and over-the-counter medications you’re taking.
  • Any recent trauma to your chest that may have caused an internal injury, such as a broken rib or pinched nerve.

Once you’re at the hospital, it’s likely that your medical evaluation will move ahead rapidly. Based on results from an electrocardiogram (ECG) and blood tests, your doctor may be able to quickly determine if you are having a heart attack — or give you another explanation for your symptoms. You’ll probably have a number of questions at this point. If you haven’t received the following information, you may want to ask:

  • What do you think is causing my symptoms?
  • Could my symptoms be due to the sudden unexpected death of my partner, as I’ve never had any symptoms like this before?
  • What kinds of tests do I need?
  • Will I need to stay in the hospital?
  • What treatments do I need right now?
  • What are the risks associated with these treatments?
  • What are the next steps in my diagnosis and treatment?
  • Do I need to follow any restrictions in my diet or exercise routine after returning home?
  • Should I see a specialist after returning home?

Don’t hesitate to ask any additional questions that occur to you during your medical evaluation.

What to expect from the doctor
A doctor who sees you for chest pain may ask:

  • What are your symptoms?
  • When did you first begin experiencing symptoms?
  • Have your symptoms gotten worse over time?
  • Where does your pain seem to start?
  • Does your pain radiate to any other parts of your body?
  • Does your pain momentarily increase with each heartbeat?
  • What words would you use to describe your pain?
  • Are you having any trouble breathing?
  • Do your symptoms include nausea or vomiting?
  • Do your symptoms include dizziness or lightheadedness?
  • Does exercise or physical exertion make your symptoms worse?
  • Does anything else seem to make your pain worse?
  • Does anything seem to make your pain better?
  • Are you aware of any history of heart problems in your family?
  • Are you being treated or have you recently been treated for any other health conditions?
  • Have you ever been diagnosed with gastroesophageal reflux disease (GERD)?
  • What medications are you currently taking, including vitamins and supplements?
  • Do you or did you smoke? How much?
  • Do you use alcohol or caffeine? How much?

Tests and diagnosis

If your doctor suspects you have broken heart syndrome, he or she will use these exams and tests to make a diagnosis:

  • Personal history and physical exam. In addition to a standard physical exam, your doctor will want to know about your medical history, especially whether you’ve ever had heart disease symptoms. People who have broken heart syndrome typically don’t have any heart disease symptoms before they’re diagnosed with broken heart syndrome. Also, your doctor will want to know if you’ve experienced any major stresses recently, such as the death of a loved one.
  • Electrocardiogram (ECG). In this noninvasive test, a technician will place wires on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor detect irregularities in your heart’s rhythm and structure.
  • Chest X-ray. Your doctor will likely order a chest X-ray of your chest to see if your heart is enlarged or has the shape that’s typical of broken heart syndrome, or to see if there are any problems in your lungs that could be causing your symptoms.
  • Echocardiogram. Your doctor may also order an echocardiogram to see if your heart is enlarged or has an abnormal shape, a sign of broken heart syndrome. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart’s structure and function. Ultrasound waves are transmitted, and their echoes are recorded with a device called a transducer that’s held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.
  • Blood tests. Most people who have broken heart syndrome have an increased amount of certain enzymes in their blood. Your doctor may order blood tests to check for these enzymes to help diagnose broken heart syndrome.

Treatments and drugs

There are no standard treatment guidelines for treating broken heart syndrome. Treatment is similar to treatment for a heart attack until the diagnosis is clear. Most people stay in the hospital while they recover.

Once it’s clear that broken heart syndrome is the cause of your symptoms, your doctor will likely prescribe heart medications for you to take while you’re in the hospital, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers or diuretics. These medications help reduce the workload on your heart while you recover and may help prevent further attacks. Many patients make a full recovery within one to two months. Ask your doctor how long you will need to continue taking these medications once you recover.

Procedures that are often used to treat a heart attack, such as balloon angioplasty and stent placement, or even surgery, are not helpful in treating broken heart syndrome. These procedures treat blocked arteries, which are not the cause of broken heart syndrome. However, coronary angiography is often used to diagnose exactly what’s the cause of the chest pain.

Prevention

There’s a chance that broken heart syndrome can happen again after a first episode. There’s no proven therapy to prevent additional episodes; however, many doctors recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart. Managing stress in your life is also important.

DS01135Feb. 10, 2011

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NEW YORK TIMES LINK:

http://well.blogs.nytimes.com/2012/01/09/really-the-claim-grief-can-cause-a-heart-attack/?partner=rss&emc=rss

PATRIOT LEDGER:

http://www.patriotledger.com/news/x2079020136/Broken-heart-syndrome-after-loss-of-loved-one