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Small study: ‘Broken heart’ syndrome increasing amid pandemic

A small study published Thursday claims it has found a significant increase in "broken heart syndrome" at two Ohio hospitals among some patients who don't have COVID-19.
(David J. Phillip | AP)
Published: Jul. 9, 2020 at 9:16 PM EDT
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(WVLT/CNN) - A small study published Thursday claims it has found a significant increase in “broken heart syndrome” at two Ohio hospitals among some patients who don’t have COVID-19. According to researchers, this could suggest that the physical, social and economic impacts of the pandemic are taking a physical toll.

Stress-induced cardiomopathy, often called “broken heart syndrome,” occurs when the heart muscles weaken, leading to chest pain and shortness of breath. It presents like a heart attack, but is triggered by stress, and in some cases, it can be fatal, CNN reported. Most patients usually recover within days or weeks.

Researchers at the Cleveland Clinic said they studied patients at two Ohio hospitals with heart trouble who were treated in spring 2020 and compared them to patients with similar issues over the last two years. According to their data, patients during the pandemic were two times likelier to have broken heart syndrome. The study was published in the medical journal JAMA Network Open.

CNN reported that the researchers looked at 1,914 patients from five two-month periods, including sampling more than 250 patients hospitalized in March and April, during the early days of the pandemic. Researchers concluded that the increase in the syndrome was likely connected to the “psychological, social, and economic stress” caused by the pandemic, which includes “imposed quarantine, lack of social interaction, strict physical distancing rules, and its economic consequences in people’s lives.”

"The pandemic has created a parallel environment which is not healthy," said Dr. Ankur Kalra, the cardiologist who led the study. "Emotional distancing is not healthy. The economic impact is not healthy. We've seen that as an increase in non-coronavirus deaths, and our study says that stress cardiomyopathy has gone up because of the stress that the pandemic has created."

CNN reported that the research didn’t look at whether there was a connection between the syndrome and the stress of having COVID-19 or watching a loved one suffer from the disease; however, the researchers said the patients in the study were tested for coronavirus and none had positive results.

The study has its limits, CNN reported, as researchers said they only reviewed medical records from patients in northeastern Ohio and more work would be needed to find out if the same is true of other parts of the country.

The new study didn't find any meaningful change in the death rate between pre-pandemic patients and those who were hospitalized in March and April of this year, researchers said.

One expert on broken heart syndrome raised concerns about the potential for bias in the study.

“They might be completely right. I don’t object to the hypothesis. I object to the statistical methods,” said Dr. John Horowitz, an emeritus cardiology professor at the University of Adelaide in Australia, who has published more than 20 peer-reviewed papers on Takotsubo. CNN reported that the researchers only studied patients who received a cardiac catheterization, a procedure done to search for blockages in heart arteries. Horowitz said looking at only those patients could lead to biases because it might exclude older, sicker patients who are less likely to undergo the procedure.

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