stress management

Emotional heartache can lead to real heart disease conditions

Dr. Larry Weinrauch Health Pro April 08, 2008
  • Few stressors are as powerful as the loss of a cherished family member or relative. Every doctor has several stories to tell about the effects on a patient.

     

    My most dramatic two stories involve the loss of a husband leading to a visit to my office. In the first, a previously very healthy 60 year-old woman awoke to find her husband dead in bed next to her. Over the next several days, and through the wake, she had begun to feel palpitations and dizzy spells along with profound "heartache" along with a profoundly disordered sleep cycle.

     

    She went to her internist after a week or two, complaining of an empty feeling and pressure in her chest. An electrocardiogram revealed quite significant numbers of extra beats with runs of a dangerous arrhythmia called ventricular tachycardia. Due to these arrhythmias she was sent to me in consultation, and eventually admitted to the hospital. Tests demonstrated the absence of a heart attack, or significant cardiac abnormalities and she was discharged from the hospital fairly quickly. Her sons became quite concerned that both parents now had given them risk factors for heart disease. Both underwent further medical evaluation that excluded any cardiac problems but still they expressed considerable anxiety. As for their mother, her normal grieving progressed, and her arrhythmias disappeared without leaving any residual problem. Twenty years later she continues to have no evidence of significant heart disease.

     

    The second patient also lost her husband suddenly to a heart condition when she was 75 years old. Although she had been known to have high blood pressure, high cholesterol and diabetes she had never suffered any prior ill health. Her grief, however, over the death of her husband from an intracranial hemorrhage was made worse when her 50 year-old son suffered a sudden intracranial hemorrhage at his father's funeral. The son followed his father in death within the next few days. Her daughter was quickly screened for an intracranial aneurysm and when one was found, she underwent an uneventful and succussful surgery. Meanwhile, her mother had lengthy bouts of arrhythmias and a profoundly disordered sleep cycle for several months. A work up did not reveal any evidence for heart damage or coronary heart disease. Both mother and daughter were fine some fifteen years later when I last saw them (they have since moved out of town).

     

    These two cases illustrate some of the issues that we see when someone in the family dies:

    • Grieving is a powerful emotion that can have physical effects on our autonomic system and can even cause life threatening arrhythmias or bursting of weakened blood vessels. Grieving, however, is a natural and normal process, that resolves with time.
    • Disorders of the sleep cycle can be quite worrisome and include insomnia (inability to fall asleep, or inability to remain asleep for a reasonable duration) or hypersomnia (need for too much sleep).
    • "Heartache" can be a cause of a very uncomfortable feeling in the chest that can be quite concerning
    • There are hereditary linkages that may go beyond just "risk factors". In the second case, the daughter' s life was saved by the recognition of a high risk that she, like her father and brother, had a cerebral aneurysm, and that hers had not yet ruptured.
    • A death in the family can motivate people to undergo a much-needed work up that they have previously been unwilling to consider. In the first case, both son's had previously declined to consider regular medical check ups
    • Unfortunately there are also cases of grieving that don't get discussed, and their recognition can be just as important in health and the healing process (examples may include infertility, progressive disease such as Alzheimer's, HIV, mental illness, miscarriage, etc.)

    For those who are going through the grieving process, please accept my sympathy for your loss. I hope that you and the other members of your family have no other problems, but do suggest that you let your health care provider no of your situation so that proper help can be afforded you if you need some.