Doctor, she's just too upset. How could her heart have problems? "Family members of patients often ask in the cardiology ward. 72 year old Aunt Wang is a typical example. She was originally physically strong, and there were no obvious abnormalities in the cardiac ultrasound results during her physical examination a year ago. But on the second day of her husband's sudden illness and death, she suddenly felt severe chest pain, difficulty breathing, accompanied by nausea, vomiting, and sweating when she woke up in the morning. When sent to the hospital, all examination indicators pointed to acute myocardial infarction - but the truth was surprising. Coronary angiography showed that her blood vessels were unobstructed, while cardiac ultrasound captured a peculiar scene: the apex of the left ventricle remained motionless, while the base contracted normally, and the entire heart turned into an "octopus pot" shape. This is not a heart attack, but a broken heart syndrome. ”The diagnosis I gave made the family suddenly realize that 'heart meridian damage' is a real medical condition. Fortunately, after a week of active treatment, Aunt Wang's heart function gradually recovered and she was discharged smoothly. The medical truth of "heart meridian damage" in the context of traditional Chinese medicine describes a sub-health state of physical and mental exhaustion and emotional exhaustion: when excessive sadness, anxiety, or long-term stress consumes the heart's qi and blood, it will affect the function of the heart controlling the blood vessels, leading to a series of physical and mental symptoms. In traditional Chinese medicine theory, "the heart governs the blood vessels" is a core concept. The "heart meridian" here not only refers to the physiological system of the heart and blood vessels, but also includes the complete system of the mind, qi and blood, and meridians. This understanding is surprisingly consistent with modern medical discoveries - emotional stress can indeed directly affect heart function. At the end of the last century, Japanese doctors first discovered a special type of heart dysfunction patients: they are mostly middle-aged and elderly women who often experience acute myocardial damage after experiencing strong emotional shocks (such as bereavement, fear, and sudden accidents), resembling a heart attack, but cannot find the blocked blood vessels. Due to the appearance of the patient's ventricular angiography resembling the traditional Japanese "takotsubo" shape, this disease is named after it. Subsequently, multiple studies worldwide have confirmed that emotional or physical stress can trigger a transient and reversible myocardial contraction disorder. Therefore, the medical community metaphorically refers to this "heart damage" as Takotsubo syndrome or stress-induced cardiomyopathy. Heartbreak syndrome is easily mistaken for myocardial infarction. Their symptoms are almost the same: sudden chest pain, dyspnea, cold sweat and even syncope. But a careful examination reveals the key difference between the two: in myocardial infarction, the coronary arteries are blocked by blood clots, and the myocardium dies due to ischemia; The coronary arteries of heartbroken syndrome are usually unobstructed and not significantly blocked. On cardiac imaging, abnormal movement of a certain part of the left ventricle can be seen - often due to weak contraction in the apex or middle of the heart, while normal contraction is observed in the base. Cardiovascular specialists need to combine multiple indicators to determine whether there have been recent intense stress events; Whether the electrocardiogram and myocardial enzymes are elevated but not consistent with infarction; Whether the coronary arteries are unobstructed; Is the cardiac motion pattern displayed by ultrasound or magnetic resonance imaging typical. In addition, the InterTAK scoring system can also be used to assist in diagnosis. This rating was proposed by an international research team and can assess the likelihood of heartbreak syndrome based on symptoms, triggers, gender, and other factors. So, heartbreak syndrome is a stress-induced heart disease that appears to be a heart attack but is not actually one. When we experience immense sadness or fear, our bodies suddenly release a large amount of stress hormones such as adrenaline, leading to excessive excitement of the sympathetic nervous system. These hormones have toxic effects on myocardial cells, causing the heart to temporarily 'paralyze', especially with a significant decrease in systolic function in certain areas of the left ventricle. The European Society of Cardiology points out that the mechanism of this disease is mainly related to myocardial toxicity caused by "stress hormone surge". In other words, an 'emotional storm' can really shock the heart. Moreover, heartbreak syndrome is not the only heart event triggered by emotions. Research has found that in some patients with coronary heart disease, reduced myocardial perfusion or local systolic dysfunction can be detected simply by watching tense videos or recalling angry scenes - this is known as psychological stress-induced myocardial ischemia (MSIMI). It can be understood as' transient myocardial ischemia caused by emotional stress', and heartbreak syndrome is an 'extreme version' of this process, manifested as more severe myocardial contraction disorders. The mechanisms of the two are similar: excessive sympathetic excitation+microvascular spasm+catecholamine toxicity. Unlike MSIMI, which usually does not show significant decline in heart function, heartbreak syndrome may result in acute heart failure or even shock. It can be seen that the power of emotions is far stronger than we imagine. When a person experiences strong sadness, anger, or anxiety, the "stress hormones" in the body will skyrocket in a short period of time. This' chemical storm 'can cause sudden constriction of the heart's blood vessels, disrupted blood flow, and even lead to brief fainting of myocardial cells. Some people only experience transient myocardial ischemia (psychological stress-induced myocardial ischemia), manifested as chest tightness or mild chest pain; And for others, their hearts suddenly "shut down", forming a typical heartbreak syndrome. The two are actually different outcomes on the same emotional chain: one is mild ischemia, and the other is severe functional disorder. How to make the heart more resilient? Does heartbreak syndrome need treatment? Of course it is necessary. At present, the main treatments for heartbroken syndrome are supportive therapy and symptomatic treatment. Most patients' heart function gradually recovers within a few days to weeks. But not everyone can be 'safe from danger'. Research has found that approximately 5% to 10% of patients may experience serious complications such as acute heart failure, arrhythmia, cardiogenic shock, and even sudden death. Therefore, this' heartbreak 'is not a completely benign disease. In other words, emotions can really be 'deadly'. How to prevent heartbreak? Although we cannot avoid sadness in life, we can make our hearts more resilient. Learn to confide in others. When faced with immense pressure or loss, do not bear it alone. Instead, confide in family and friends or seek psychological counseling to significantly reduce the risk of heartbreak syndrome; Learning to relax, meditation, deep breathing, yoga, Tai Chi and other relaxation methods can reduce sympathetic nervous system overexcitement and help the heart relax; Maintain a healthy lifestyle, exercise regularly, have a balanced diet, quit smoking and limit alcohol consumption, and get enough sleep to make the body more resilient; Control chronic diseases, hypertension, diabetes, anxiety or depression and other problems should be actively treated to reduce the cumulative impact of stress; Regular physical examinations and follow-up examinations are recommended for patients who have previously suffered from heartbroken syndrome. If necessary, long-term use of beta blockers should be followed according to medical advice. Heartbreak syndrome tells us that the heart not only beats, but also feels. Psychological health and heart health are inseparable. When immense sadness or pressure strikes, don't hold on. Crying, speaking out, and seeking help - this is not weakness, but an important protection for the heart. (Author: Chi Yunpeng, attending physician at the Double Heart Medical Center of Beijing Anzhen Hospital Affiliated to Capital Medical University) (Xinhua News Agency)