Recent research was published on Thursday that found a significant increase in "broken heart syndrome" at two Ohio hospitals among patients who were not diagnosed with COVID19. Physicians suggest that the physical, social and economic stressors from the pandemic are taking a physical toll.

The stress-induced cardiomyopathy or also known as "broken heart syndrome" (Takotsubo syndrome), appears when the heart muscles weaken and lead to chest pain and shortness of breath. It presents as a heart attack but actually triggered by stressful situations that blockages in the bloodstream. The patients usually recover within days or weeks.

The Discovery 

The Cleveland Clinic researchers examined patients at two different hospitals with heart trouble who were treated last spring and compared them to patients with related issues over the past two years. Patients during the pandemic were two times prone to have broken heart syndrome, according to the study, which was also published in the medical journal JAMA Network Open.

The research was observed at 1,914 patients from five distinct two-month periods, including a sample of over 250 patients hospitalized in March and April. It was concluded that the increase was likely connected to the "psychological, social, and economic stress" caused by the pandemic. The "imposed quarantine, lack of social interaction, strict physical distancing rules, and its economic consequences in people's lives."

According to Dr. Ankur Kalra, a cardiologist who leads the research, "The pandemic has created a parallel environment that is not healthy. Emotional distancing is not healthy." 

On the other hand, the recent study didn't examine whether there was any connection between broken heart syndrome and the stress of having coronavirus or watching a relative suffer. They tested the patients who took part in the study for COVID19, and none of their tests came back positive.

Tedros Adhanom Ghebreyesus, World Health Organization General Director, said last May, "The impact of the pandemic on people's mental health is already extremely concerning."

US Public health authorities and other countries have raised the alarm about the coronavirus's impact on mental health, paying particular attention to the isolation of socially distant living.

Research Limits

Researchers only studied the medical records from patients in Northeastern, Ohio. They noted that more work is needed to determine if these findings are valid in other parts of the country. They also added that it would be worthwhile to explore the direct relationship between COVID19 and broken heart syndrome, which wasn't part of this study.

One expert on the Broken Heart Syndrome raised questions about the recent study's methodology and pointed out several opportunities for potential bias.

Dr. John Horowitz, a retired cardiology professor at the University of Adelaide in Australia, pointed out, "They might be completely right. I don't object to the hypothesis. I object to the statistical methods." 

Researchers only examined patients who received cardiac catheterization. This procedure is commonly done to search for blockages in the heart's arteries. Looking at only this slice of patients could lead to biases in the sample, according to Dr. Horowitz said. And this study might exclude older and sicker patients, as they are less likely to undergo catheterization.

"It's well-known that patients quite frequently get Takotsubo syndrome at times of extreme stress or during natural disasters. But there are problems with the way the study was designed. I don't believe all of these cases are Takotsubo. It's as simple as that." said Dr. Horowitz.