Love, stress and broken hearts

14 February 2013
 Broken Heart by miguelpdl, on Flickr

Broken Heart by miguelpdl, on Flickr

Can you die of a broken heart? Perhaps not, but heart attacks have been known to be triggered by intense emotion and mental stress. At a Packed Lunch event last month Malcolm Finlay, Senior Clinical Research Fellow at UCL, talked about investigating the electrical and physiological mechanisms behind this phenomenon. Nancy Wilkinson was there to hear how an increased understanding may help to identify those most at risk and reduce their chance of sudden death.

Valentine’s day. For some it is a romantic day filled with chocolates, flowers and teddy bears. For others it is an excuse to gorge on ice-cream whilesinging ‘All by myself’ in pyjamas. Whatever today means to you, it all revolves around our hearts.

Cynics may say that the heart has nothing to do with love, and is just the organ that keeps the blood pumping through our veins. But having a broken heart is real. Intense emotional stress is actually quite common in triggering heart irregularities I found out at a recent Packed Lunch event at Wellcome Collection.

Dr Malcolm Finlay, cardiologist at University College London, researches how the heart copes in stressful situations, and came to Packed Lunch to tell the audience all about it. Although a bad break-up can cause a broken heart, emotional stress can be caused by lots of things, and it all has an impact on our hearts.

Finlay told us about a few notable examples where during a stressful event the numbers of heart irregularities spiked. After an earthquake in San Francisco, there was a huge increase in the number of heart attacks, and during a football World Cup, there were spikes in the number of heart attacks in Germany every time their home team played a match.

The people who suffered these heart irregularities weren’t random; they were those who were pre-disposed to heart problems already. In each case there was a dip in the number of heart attacks following the event: the people who were going to have a heart attack, had it then.

To find out what happens when we are stressed, Dr Finlay and his team measure the heart when it is put in a stressful situation. The team find willing volunteers amongst patients who are already undergoing procedures on their heart. These patients have a catheter – a thin plastic tube, with a platinum end – leading from the upper leg, through a vein into a chamber of the heart. This platinum ended catheter can measure the electrical activity of the heart, and therefore if it is beating normally. Finlay brought along a catheter to show the audience, and I have to say it was a lot bigger than expected. He explained that veins don’t contain any nerves, and are extremely stretchy, so the patient doesn’t feel any pain at all.

To get the patients stressed, he first has to relax them. He dims the lights, gets them to think of themselves on a meadow or a beach and lie quietly for three or four minutes. Then “BANG”: the lights come on and Dr Finlay is saying, “wake up, we’re going to do some mental arithmetic”.

He then tries to crank up the pressure by asking the patients to imagine themselves in the most stressful situation possible. This often produces a heightened response: in one case, a woman actually suffered a heart irregularity right there on the operating table.

Finlay said he was surprised by the results he has seen: the heart exerts itself hugely, even when just imagining being under stress. It produces a similar response as it does when getting ready for some serious exercise, but then, of course, nothing happens. This can cause serious damage, particularly in these patients who already have heart problems.

The research aims to find out how and why our hearts react the way they do to these situations. Finlay wants to find out the mechanism of how the heart responds to stress, so it can be treated accordingly, rather than just treating symptoms. The research is still in its early days, but he has already seen more results than he thought. You never know, one day he could even find a cure for a broken heart.

Nancy Wilkinson is a graduate trainee at the Wellcome Trust.