And...if a person is depressed thus also leads not just poor eating habits but more alcohol abuse. Which the doctor neglected to mention.
Medicine has to go through a revolution about the way they treat and think about patients. Often, prescribing drugs is not the solution. Yet, doctors are our biggest drug pushers!
6
My husband died two years ago, and my heart actually aches, still.
(A visit to the cardiologist revealed no physical symptoms.)
9
@Woman take care, hope you have loved ones to support you.
6
There's also the well-documented in medical literature (but seldom emphasized to patients) effect that extended periods of time being put on a heart-lung machine during open heart / bypass surgery (known as "pump-head") has on triggering major depressive disorder after surgery. There are theories as to why being on the machine can affect the brain, and the link is causal, not correlative.
3
I was hoping that Dr. Juahar, sorta sounds like mountain heart in Suisse, was talking about the beneficial effects of regular good loving and great sex on general cardiac health and the human body
s ability to heal.
My mothers father, an orphan, died in his sixties from some heart, and liver problem, he was a WWII veteran, and being an orphan, did not have any role models available, we think he was half American Indian and half Norwegian. Also my Mom and her family grew up in the early 30s during the Great Depression, which must have been very stressful on poor people. My mother's mother it was said that she died of lung cancer, she did smoke, I was told, but my Mom said she only smoked a cigarette after dinner. I believe my maternal grandmother died of a broken heart. at 49. My Mom said that her family were frequently evicted from their digs, cuz my mat.Grandfather gambled and drank away the rent $. American Indians don't have alcohol dehydrogenase enzyme and so one little drink of EtOH, completely hammered them. So my Granfather couldn't give good loving and yes, sex, we all need it, and my Grandmother died of a broken heart, not lung cancer. In the U.S., when poor people die, the rich like to say, they deserved it. I don't think so.
4
I wonder if there is data out there to discover who lives longer between Democrats and Republicans? My guess Dems because we are happier.
10
@Scott Franklin good one! A few years ago, we heard a study was done comparing the “liberal versus conservative” brain. Liberal brains are more active in the part of the brain that is credited with empathy and caring. As opposed to the conservative brain which was more active in the area if the brain known for the “lizard brain”. I’m in agreement Liberals live longer!
6
I always wondered why a very healthy person like my father suffered heart attacks and ultimately died of heart failure. He was a concentration camp survivor who lost his whole family.
This reminds us how easily we can cause pain, stress and death to others. Let’s all think before we strike.
Thank you for this research.
21
Thank you for this article. A more holistic approach to patient healthcare would be a much better way to help patients stay healthy than the current for-profit managed-care assembly line model in use.
However, if a doctor were to ask me about my emotions, stress, etc I would be EXTREMELY reluctant to answer truthfully for two very important reasons:
1. The physician hasn't known me my entire life, let alone spent more than 10 minutes per visit with me (while typing into a computer or ipad). If I were to mention that I was under stress and feeling hopeless, she or he would probably diagnose me with a mental illness and give me a prescription and referral. Doctors tend to categorize patients to fit diagnoses instead of seeing them as a human life in situational circumstances.
2. More importantly, my records would be given to my insurance company (and employer). Now my condition, whether acute or chronic, becomes a pre-existing condition, not to mention that some 20-year-old HR personnel at my office can see that I was referred for counseling.
This is one of many reason why universal healthcare that is NOT connected with employment is so important.
39
On waking up from a deep sleep this morning, I unexpectedly felt the first few faint stirrings of emotion I had felt in many years in a part of my body that is not my heart.
Whether this was a one-time-only phenomenon or not, I do not yet know.
But ---
If matters proceed in the right direction from here, I may up having something else to do with the rest of my life that is more fun than writing comments in the Times.
6
Thanks for publishing this. A couple of hours after being notified of my mother's unexpected death, I began to have heart pain. I thought of those country / western songs about heart ache and decided it was grief. Thirty-six hours later, after the pain and come and gone a couple of times, I decided to visit the ER. While checking in, I told the nurse / staff that I thought it was just grief due to the recent loss of my mother. The ER doc and nurses advised that since I had zero risk factors, it likely wasn't a heart attack, but they'd do the blood and EKG tests.
It was Christmas night, and i felt horrid when they called in the cardiology team following positive tests. The cardiologist listened, nailed it as Takotsubo syndrome, and confirmed it with an angiogram. Today, I'm just fine, but so much more aware of my heart and the fragility of life.
As I visit other medical professionals, I'm surprised I have to explain and explain this type of cardiomyopathy. Only one PA over the past 7 years has known what I'm talking about. Keep up the educational articles.
86
@AS Williamson I’ve found that we are our own best advocates, shocking what physicians don’t know.
5
I have had two of these events. The second one, the ER refused to believe it was anything to do with the heart, and told me it was a muscle injury, and go wait in the waiting room (it didn't show anything on the heart monitor) I was in excruciating pain for a couple hours, until they finally took blood and, through the enzymes, realized what was happening. I have completely recovered from them, but being a woman with a heart issue, is hard to be taken seriously.
They kept telling me if it was a "real" heart attack, I would show more pain (even though I was reporting a 8-9 on their scale). What they don't take into consideration is that those of us who have had childbirth, etc. might have learned how to deal with pain, but still feel it!
72
@kertja BTW... the first one was work related stress, and never could figure out the second. Not "love" related, but probably stress related.
2
All the men in my family died of a broken heart. My grandfathers went shortly after their wives, one by just a day. My uncle died when he found out his wife was having an affair and was leaving him. My father a few short months after my mother. It was the same with my other uncles.
And me? I am my uncle’s age, getting divorced, loving my soon-to-be ex wife the way drown sailors loved the sea.
I will survive, but only because of advances in cardiology.
52
@D Priest
Sounds like there might be a genetic susceptibility in your family. If you contacted a researcher, I bet they'd be interested, and you might help others with the condition.
1
I have ventricular arrhythmia, and am on my third ICD (first one at 44). I was commuting 100 roundtrip miles to my job everyday, a stressful high-pressure work environment.
I finally reached the end of my rope, and tried to have a heart-to-heart with my cardiologist. He nearly flipped! He asked if I’d like antidepressants, and hollered that I was perfectly capable of working.
I have never felt so cowed and insignificant in my life.
Since I had already saved a nice nest egg, I saved my own life by resigning my job.
I felt a new lease on life. And I dumped that cardiologist real fast.
137
@David G.
How dare a doctor be so anti-therapeutic. I recently saw a doctor who insisted I needed SSRI's in spite of the adverse reactions I explained. I also told him I was not depressed, that I had anxiety and twice-diagnosed PTSD. I felt bad about myself for days after seeing him. Then it occurred to me that he was the only doctor in town who actually had a sign in the window begging for patients - all other doctors have waiting lists. I only went to him for a clearance for cataract surgery and was angry to have felt demeaned by his know-it-all attitude. I'm glad you dumped the jerk; so did I.
6
My mother was 89 years old and not in the best of health but she was holding on. She was quick as a whip and still wanted to live on her own, her 4 children visited often, so often in fact that there were times she told me not to come by, she wanted to relax with a book or movie.
A series of hospitalizations dictated she have help come in a few times a week to help with housekeeping and such, in addition to a visiting nurse service. We found a woman in her late sixties who would come to my mothers 3 times a week, and being an older woman she and my mother formed a fast friendship. It was comforting to the rest of us to know someone who cared was there when her family couldn't be.
Last August my mom called us crying and extremely upset. It turns out that a few months earlier some cash had gone missing. As I said, Mom was quick as a whip and took very good care of her own finances but she assumed she had just made a bookkeeping error and let it go. This time a larger sum was missing and there was no doubt her caregiver had stolen it. My mom was in extreme duress and the next day felt she needed to go to the hospital. She passed away 3 days later from congestive heart failure..
Her primary doctor who was her nephrologist, after hearing the story, told us she died of a broken heart after having her trust betrayed by this woman. We knew she was likely not to live much longer but feel we were cheated of any time left to her. Had we solid proof we would have filed charges.
99
@no kids in NY
Very sad but all too common. Seems it's literally heartbreaking to have one's trust in others betrayed. We have to have some trust in others but even if only a small percentage of people take advantage of the trust placed in them, it is still destructive to those betrayed.
28
@no kids in NY
A neighbor of mine of 85+ years had a similar story. She was active, kind and trusting. She suspected a popular handyman of theft. Because of her age and his personality, neighbors were not as supportive as they should have been. Afterward she was depressed and anxious and died shortly thereafter. Though never formally charged or even accused, he ended all dealings with the building. If she were 20 years younger, there would've been a totally different outcome because of her suspicions. The elderly are very vulnerable and often not believed when it comes to theft by "trusted" employees.
62
It's so interesting how much stress affects our health. Yet here in America we're supposed to suck it up. The culture needs to change so there's more focus on emotional health. Doctors can certainly help by discussing stress with patients.
Chest pain and shortness of breath are also typical symptoms of a panic/anxiety attack. I'm surprised the good doctor didn't mention that.
49
I was on a scuba diving trip in a remote area of the Philippines when one of our group had a very stressful experience after surfacing from a dive. She showed symptoms of a major heart attack and was eventually air-lifted to Manila where they decided to do a cardiac cath. As they inserted the catheter all her signs suddenly returned to normal and she was discharged after a few days with no one being able to figure out what had happened. She eventually went to the Mayo Clinic for a workup and they determined she had suffered takotsubo cardiomyopathy due to the stressful experience she had after surfacing from the dive. It was definitely an extremely serious life-threatening situation when it occurred.
43
One of my (less astute) patients developed a cardiomyopathy so severe that he became a candidate for transplantation. As I discussed this with him he expressed the fear that after the procedure he might for example not feel the same way about his wife. I reassured him that we were not discussing his “heart” in that sense and that no such thing would occur. He went ahead with the procedure and soon felt much better.
Then he dumped her.
104
@Richard Williams MD
I had an MI 5 years ago at the end of a very stressful and awful marriage. I should have left her years earlier. Interestingly, her first reaction when she heard I had a heart attack was "It's not my fault! I didn't give you a heart attack!"
7
Economic stressors should also be considered.
I've never had a doctor ask me how that's going in my life.
It is related to a lot of health related problems including mental ones. Losing ones job can put some people over the edge.
208
@Kelly
I'm sad to know no doctors have ever asked you what's going on in your life. My cardiologist ALWAYS asks that question first at every office visit. I feel very lucky to have him taking care of my heart. And my former primary care doctor did the same. It's too bad more physicians don't get the mind/body connection.
6
@PKN
I tell PCP and cardiologist anyway, whether they ask or not--it's important for them to know what's going on in their patients' lives as this article illustrates.
1
Nothing new about any of this.
For at least 25 years we've known that the most common cause of non-cardiac chest pain are anxiety disorders. Sadly, most of these patients (and despite what Dr. Jauhar appears to be saying, they are both men and women) usually come to emergency departments multiple times thinking they might be having heart attacks and get expensive work-ups which, of course, are negative. It is usually almost after many such visits and after tens of thousands of dollars of worthless tests are performed that a psychiatrist is called into consult.
Obviously most patients and doctors would prefer patients get the wrong diagnosis of a physical disorder than the correct one of a psychological one.
36
Perhaps one of the first “reports” of what we now recognize as Takatsubo Cardiomyopathy is detailed in Daniel Defoe’s “Journal of the Plague Year”.
He describes, with great verisimilitude, the sudden death of immediate family members of those stricken with plague in 1665; their bodies showing none of the stigmata of the disease.
3
Another prescription: Stop reading The New York Times.
The real horrors and the forecasts of others, as well as the agendas that put everything into a negative socially "relevant" context, will drive you to despair.
There's nothing one can do about most of what's so bad except experience a rise in dread.
4
@geebee being informed is beneficial. This article is a great example of this! Of course, do what you want.
3
And some of us may prefer to simply drop dead.
5
Nice essay. but doesnt explain the mystique as to the difference between a broken-heart - *psychological damage* such as from experiencing the loss of near one,
and *physiological damage* to the heart's function due to physiological factors including eating too much, snorting too much or even making love too much..
Great article which should be required reading for all. Immediately! A subject so painfully obvious yet so often overlooked and misunderstood, it begs to be placed right alongside
CPR in terms of its lifesaving results.
3
Very good article. Happiness is the key for better health. If we look for happiness in each and every minor thing we do such as spending time with our family and friends or someone else does for us, our heart will be healthy and then everything will be fine.
As far as family tragedy is concerned, it’s beyond us. We can plan precious little about it and we are left with no choice but to accept the fate as it happens.
If we are gloomy and sad all the time even when certain minor incidents happen in our lives, surely we will be in trouble health wise and money wise.
If you’re interested in this, I recommend reading about the Roseto effect.
2
Partially explains why so many people pass away shortly after their spouses.
6
Love these articles, gives more reasons to snuggle in bed longer on Sunday!
10
My Heart and I
BY ELIZABETH BARRETT BROWNING
I.
ENOUGH ! we're tired, my heart and I.
We sit beside the headstone thus,
And wish that name were carved for us.
The moss reprints more tenderly
The hard types of the mason's knife,
As heaven's sweet life renews earth's life
With which we're tired, my heart and I.
II.
You see we're tired, my heart and I.
We dealt with books, we trusted men,
And in our own blood drenched the pen,
As if such colours could not fly.
We walked too straight for fortune's end,
We loved too true to keep a friend ;
At last we're tired, my heart and I.
III.
How tired we feel, my heart and I !
We seem of no use in the world ;
Our fancies hang grey and uncurled
About men's eyes indifferently ;
Our voice which thrilled you so, will let
You sleep; our tears are only wet :
What do we here, my heart and I ? (Thank you for this beautiful article, Dr. Jauhar.)
34
***meditate***
I've meditated for 45 years and my blood pressure is still 110/70. Even in the age of Trump.
***meditate***
It's a daily vacation from stress... a rest deeper than sleep... and the effects are cumulative.
***meditate***
26
r@WernerJ yes! Meditation! I started in ICU after a major “medical event” and it’s been very beneficial. Healthcare providers should cover the cost of learning to meditate.
6
Shame on the New York Times Corporation for helping a misguided provider spread subversive ideas! (As we all know, providers are factory floor workers in the medical-industrial complex. They were called "physicians" in the dark days before wealth care for shareholders replaced health care for patients as the exclusive focus of American medicine.) He calls emotions and mental health factors essential for patient care-- even though individual considerations like that destroy shareholder value!
Considering a patient's emotional state means wasting time talking to patients. That damages productivity metrics. Even worse, it distracts providers from their primary task of typing into their computers all the precious data that generates billing codes!
The worst thing about this article is that Provider Jauhar seems to be implying that medicine is about health care for patients. That's dangerously wrong!
Along with incarceration rates and income inequality, our medical-industrial complex is one of the crown jewels that makes the United States Exceptional in the world! Only in America is medicine synonymous with wealth care for corporate executives and shareholders rather than health care for patients. With his destructive suggestions, Provider Jauhar might as well be promoting the unpatriotic idea of replacing our unique and precious medical-industrial complex with the sort of socialist health care system lesser countries have. And we certainly don't want that!
46
So how do you treat a broken heart?
Entire genrations of songwriters want to know!
Everything from country and western to Memphis blues is tied up with this.
6
You are obviously transcending cholesterol and blood glucose.
1
@Norbert Voelkel they are affected by emotions, too. There is no line at the neck.
3
I bet the president can also have a measurable impact.
An inspiring, hope giving, with uplifting stellar ethics president may have an epidemiological measurable impact prolonging lives.
Alternatively a degenerate, ethically challenged, lying no-good bully may also have a statistically discernible impact shortening lives.
46
Traditional Chinese Medicine has known this for many centuries, good to see the West is finally catching up.
20
Really great essay by Sandeep Jauhar. Yes, stress isn't good, cardiovascular or otherwise. It's interesting that there can be recovery after takotsubo.
For athletic events, there doesn't seem to be the same effect. Groups of us would do severe hill sprints, both running and cycling. Then there are races where participants go all-out. Clearly, there *are* heart attacks in these cases, but it seems as if the athletic stress has revealed cardiovascular disease, not caused it.
But one isn't just going to run a marathon; there is a lot of training involved. That must prepare the heart for that planned, physical stress. For personal tragedies, we aren't prepared. But does athletic training prepare one for personal tragedies?
Cardiology has come a long way, as Sandeep tells us. In some sense, it's miraculous. But having a good diet and exercising gives the cardiologist a head start if there is something wrong with your heart. Also, if you are having heart problems, you always hope the Yankees are winning, which helps avoid a case of takotsubo.
As for personal tragedies other than a losing Yankees (about which you can always complain to friends), it is always good to talk about them and share them with others. There is the feeling of a great weight being lifted from the chest, maybe signaling the end of takotsubo.
6
And how many cases of heart problems are self-inflicted, that is, come from the way a patient tells himself the story of his life?
With a late in life marriage, he was having not-unexpected changes in his sexual performance that could have been addressed by us together. But instead, he blamed it on me and after his cardiac ablation, when the doctor said "no sex" for a week, I wanted to laugh or cry. Try 6 years of no affection, cuddling, nothing.
8
@L D
Dump him.
8
One of my standard questions during the Review of Systems on a man 50 or older is “how are your erections?” It takes a good blood supply to produce a good erection. If erections are poor he probably has plugged coronary arteries. This is much more important than his sex life at age 70.
A Minnesota family doctor.
15
I read a great book by two esteemed physicians with several other Physicians contributing. It was titled "the ending of medical reversals", something like that. Point was, so called trials are encouraged to prove better what works, as opposed to what is supposed to work, but has turned out not to work. As we all know, the medical profession seems to always be changing their minds. With that said, many of us try to follow todays advice. My favorite was blood pressure going from being okay at 140/80 now to 120/80 or less. Then there was get a PSA every year, to now discuss it with your doctor . My point being, we can try and eat what is recommend, (always changing), exercise to specific numbers of minutes or type exercise, etc etc., and as the author points out, folks still have cardio issues. Is it just a muscle, or or can all the other issues mentioned, cause problems?
4
@Dan Green most physicians do not treat the whole person. That is a problem.
1
I have now seen your “broken heart syndrome” in all of my “throw aways” journals. That’'s what magazines with ads in them are called.
My peer review journals do NOT have advertisements or non-clinical research such as yours.
1) Men have heart attacks when having an affair. They are secreting boatloads of adrenaline cheating on their wives. New woman, unfamiliar territory--hotel perhaps, the heart kicks into high gear, fear of getting caught. Plain old same-o, same-o sex with the spouse not so much. I can’t count the number of heart attacks and DEATHS from heart attacks called in from houses of “ill repute” where you can buy the services of a woman or boy. Ask ANY homicide detective!
Nelson Rockefeller comes to mind...
2) Cardiologists spend about 45 seconds with a patient. They don’t ask ANY history. No today’s cardiologist is in there to MAKE MONEY! I know! I’ll send a patient in for a heart consult, then he sends the patient to the ER. My best friend is head of the department of emergency medicine and he said “I have enough to do with my staff seeing colds as they can’t afford health insurance--(Thank you GOP and Trump!) without doing work-ups for you cardiologists. It also happened to me. I have zero breathing problems even after using a push lawn mower for my 1/2 acre lawn, I’m 70 years old.
I saw a cardiologist to get a new lipid lowering agent. Only a cardiologist can prescribe.To ER! $29,500 for 24 hrs of testing! ALL normal.
Ask your cardiologist..HA!
16
Yes, as Dr. Jauhar writes it is "increasingly clear that our hearts are sensitive to our emotional system". Our emotional systems have been tested en masse for the past two years by the erratic unhinged Trump presidency with dire consequences. It is an aspect of this pernicious volatile period that should be addressed by medical professionals. I have yet to read an article which speaks to the health consequences on the population of this nerve wracking unstable period with its constant high state of anxiety.
25
meditate
4
A brief, cautionary tale for menopausal women, and those that love them. I’m almost 60. Several years ago, over about a one year period, I had four separate episodes requiring a trip to the Emergency Department. This was extremely high blood pressure, SOB ( shortness of breath ), cold/clammy skin AND the dreaded sense of impending DOOM. Yes, the symptoms of an impending heart attack. Except, all my lab results were normal, my EKG was fine, I had no arrhythmias. A cardiac catherization was actually suggested by the ER Resident, I refused. It was all due to Anxiety. DUH. I finally got that prescription for Xanax, to take only during the panic attacks.
I’ve avoided the ER since, and take low doses of two well known antidepressants since. Funny enough, I never had any symptoms or problems with elevated BP while traveling. The place you live can definitely affect more than your physical health, especially if you loathe being there. I’m just waiting it out until we can retire, and move. For good.
Best wishes.
20
Not a single mention of cortisol and the adrenal glands? That's a shame. Consider adding coffee (caffeine) into the equation as well.
7
Yes so true.......I feel like I am dying a little......each time one of my family members dies from an endocrine cancer.
Mom.....pancreas......I was 42 and had my first arrhythmias
Baby sister......age 49 .....stage 4 ovarian....she had metastasis
Everywhere......i had hypertensive crisis hospital visits 8 times in last 7 years.....
Middle sister...stage 3 breast cancer....alive in treatment
Father.....prostate,colon,stomach cancer.......i had a brainstem stroke.
And a slew of aunts ,uncles ,cousins with Cancer.
Currently I went from stage 1 heart failure to stage 2.
Ventricles do not empty completely,and past March a brain stem stroke causing vision issues.
I am a retired nurse with a broken heart.....i know that was the cause....each death takes another piece of my heart.....
A song about that.
18
My cousin died. Her mother, unable to withstand the grief, died a few days later.. the funeral was moved from Friday to Sunday to accommodate.. and it was a double funeral.
11
I experienced terrible chest pains in my heart area in mid-20s during a particularly vicious period of emotional abuse from my ex-husband. At that time, I wondered if such symptoms were normal or if I were just a bizarre case. Despite being diagnosed with a mitral valve prolapse in my teens and having been on beta-blockers for severe tachycardia in high school, it never occured to me to go to the doctor for my fear and grief induced heart pains. I thought I was just weird.
22
Of course the heart responds to autonomic nerves, but why do you cal the fight or flight response "maladaptive"? It wouldn't have evolved if it was.
10
@turbot Perhaps the response is called "maladaptive" because it can result in death?
5
Thanks for the scientific explanation of what we have known all along.
19
I am 82. Married. Last year, at my annual checkup my doctor took blood and did the accompanying this and that and then asked a lot of questions. At the end I said to him, you didn't ask about my sex life. He got ready to respond, but I cut him off at the pass. "What sex life."
I also get a laugh if I go to a physical therapist for some mechanical ailment and on the first visit have to fill out forms. There is always a question on the form, is the ailment, whatever it is, interfering with your sex life. To which I write, in big letters, "What sex life."
My heart, by the way, always comes up aces on the EKG or whatever is used to test it.
6
This is not an opinion piece - it belongs in health or science. We know well that people actually can die from a broken heart. I'm not sure what cardiac therapy can be deployed to help with a messed up love life.
20
Several years ago Marina a beautiful woman died almost immediately after Augusto her handsome husband of many, many years passed away. They were always a loving and luminous couple. He was a successful engineer and a caring father and grandfather. She was not able to live without him and her heart had the mercy of stopping working forever, when she realized what was lost.
We had to go to a funeral with two coffins. Very sad situation. But after thinking for a while we decided that Marina was blessed.
No, we should not call the cardiologist when the love of our life dies. "Who lives forever anyway?" Says the song.
8
The question is whether an insurance company will compensate a doctor for taking the time and care to help a patient emotionally. I very much doubt it.
30
@FilmMD
The answer is yes. Insurance companies do. The questions really are:
1 - Will cardiologists ask about 'mental' health?
2 - Will cardiologists bill for time talking to patients instead of procedures which pay less by the hour?
11
Thank you for yet another thought-provoking and informative article, Dr. Jauhar. As a younger (under age 50) cardiac patient, it’s refreshing to read cardiology-related topics that are relatable to me. Kudos!
17
Another big factor in heart disease and high blood pressure is traffic and aircraft noise. People who are stressed by noise often try to live in quiet areas but unfortunately frequent re-routing of aircraft (especially in the New York area) make this difficult or impossible. Low-flying aircraft are literally killing people, even when they don't crash.
29
Tranquility is the key to a long life in my opinion as well as a minimum of serious physical ailments which in turn can be brought on by one’s lack of peace.
28
I had a patient diagnosed with takotsubo by cardiac cath after the death of her son from muscular dystrophy. After the next son died of the same illness 3 years later she worsened considerably and ultimately died herself. Her remaining - and unaffected - son and I both believe the burden of caring for 2 children and watching them die was too much. Doctors grieve for - and with - their patients and I think of her often.
116
Dr. Jauhar, You are absolutely correct that the cardiologist or other physicians attending the patient needs to ask him/her all these questions. I do recall our (i did not say 'my') Family doctor asking a lot of questions re our lives. But that was then when there was a personal relationship between the Family Doctor and the Family. They knew what was happening with the family. Now we do not have time to ask the patient barely their date of birth let alone about love life. These items certainly would be possible once we change the basic structure of Healthcare Delivery System. We need to prioritize Health care instead of what is allowed by the insurance companies.
Switch to a Single Payer System from the current Profit/Bottom line based Health Care Delivery System. Health Care is a basic Human Right not a choice as the Republicans would want you to believe.
109
@Wizarat Yes! And Single payer would also let physicians shed the expensive sub-offices devoted to figuring out the dozens of rules and regulations forced on the US by our disastrous for-profit health insurance system.
14
I don't have a cardiologist.
However, I am hoping to go to bed one night in 15-20 years (the excepted number of year I have left based on genetics, statistics and life style) and NOT wake up.
That's the best ending a person could wish for.
And only a heart attack promises such a swift and painless end.
32
@Jay David
Cardiac arrest (without resuscitation) could cause a swift and painless end. A heart attack might instead result in hospitalization and medical treatment.
9
@Jay David heart attacks are not painless! Ask anyone who's survived one.
4
What an important message. My father had a very traumatic childhood and was emotionally closed off as an adult. He suffered from arrhythmia and congestive heart failure for 25 years and died an early death despite receiving the best possible medical care. The link between his bottled-up emotions and "broken" heart was clear. Therapy and self-reflection are medicine.
56
I have long thought that in this age of churchlessness for many -- a therapy group is a good thing for one and all. One does not have to meet expectations in a therapy group as one has to do with friends. (Friends are not enough! nor is a single shrink.)
Sound mind, sound body -- a pretty old formula. Sleep a major component in healing can be easily affected by emotions, stress eating or not eating...etc. as well as all the things the good doctor mentioned.
UNIVERSAL SINGLE PAYER MEDICAL CARE NOW.
80
I don’t have the space to include an example that affected me (seriously, it would fill essays) but Yes, yes and yes - I could not agree more. Another thing - the stress and pain of a breakup or relationship problems can also distract you from physical symptoms that need to be taken seriously ASAP. I suddenly got hammered by near-kidney failure (heart-related) but because the marital stress at home was so much, I had assumed the tiredness and general awfulness in the weeks beforehand were side-effects of the stress and lack of sleep. They weren’t, as I discovered in the Emergency department.
Still, the hospital was an oasis of peace after the preceding weeks.
27
takotsubo cardiomyopathy - broken heart syndrome is real.
31
Humbert Humbert, would definitely be a case in point to study regarding this matter.
8
I thought the article would stress the fact that impotence may be the first sign of significant vascular disease and physicians should ask about it as part of the history.
Takatsubo heart shows the consequences of a huge sure in adrenalin brought on by acute severe psychic stress. Chronic stress from lack of psychosocial support is more insidious but just as deadly.
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@Edward Blau The first thing I ask a new male patient is whether he wakes up with a erection. His answer bears heavily on my decision to work him up for cardiocascular disease. I seldom regret it.
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@Paul Bunten.
Since I’m not equipped with an erectible appendage is there another sentinel physical manifestation women should know about?
If not, likely, this may explain the different heart attack symptoms women experience resulting in misdiagnosis and/or delayed treatment.
My late husband’s bicuspid valve deformity didn’t cause symptoms until his late 60s instead of his early 50s. Doctors were surprised. I think Dr. Bunten’s question has solved the mystery.
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I'm surprised this piece didn't mention anything regarding the vagus nerve and its pathways to the organs, including the heart, and the stress response.
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