Extreme emotional shock can come with fatal cardiac consequences, writes sian_harding
. Exactly the same triggers are involved in sudden cardiac death, but the death rate is far lower—around 5%.
While there is an immediate danger to life from the heart failure, the most striking phenomenon is that—days or weeks. Patients can walk out of hospital apparently perfectly well. Chronic heart failure this severe is usually very persistent and hard to reverse, even with the best treatments. . Rats were anaesthetised, and given a dose of adrenaline which would be equivalent to a single epi-pen treatment in a person. Amazingly, just this one dose was able to produce the Takotsubo pattern of paralysis at the apex of the rat heart, and the effect was reversible as the dose wore off over the course of a hour.
Our rats were given the blocker together with adrenaline to try to stop the Takotsubo effect, and it worked. The contraction of the heart was not depressed. But, to our dismay, blocking the new pathway also triggered massive arrhythmia. The high dose of adrenaline was overstimulating the heart and flooding the cells with an excess of calcium. Now, the adrenaline was mimicking the effects seen in sudden cardiac death, with ventricular fibrillation and rapid failure of cardiac function.
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