Stress of summer of bushfires putting older women at risk

“Broken heart syndrome” is on the rise as older women dealing with severe emotional stress – possibly linked to the summer of bushfires – suffer adrenaline-linked heart inflammation.

• Debbie Reynolds dies after death of daughter Carrie Fisher
• Get the most from your Advertiser digital subscription

A sudden spike in dangerous “broken-heart syndrome” victims – possibly linked to the horrifying bushfire season – has prompted a prominent cardiologist to call for a national health alert for older women.

Five cases have been recorded in Adelaide hospitals in the past fortnight – more than double the average of about one a month.

And experts fear many more may be going undiagnosed.

Professor John Horowitz, pictured, who has researched the condition for more than a decade and published multiple papers, fears sufferers may be mistakenly assessed as having heat exhaustion rather than potentially deadly inflammation of the heart.

Professor John Horowitz.

The condition, formally known as takotsubo cardiomyopathy, is a weakening of the heart’s main pumping chamber, usually as a result of a rush of adrenaline linked to severe emotional or physical stress.

While this may be the sudden loss of a loved one – hence the nickname “broken-heart syndrome”, based on older women suddenly dying after losing their partner – it can also be triggered by a serious accident or natural disaster.

The name takotsubo comes from the Japanese word for octopus, due to the change of shape of the heart’s left ventricle.

Prof Horowitz said the condition almost exclusively hit older women, including those in relatively good health.

“We’ve been looking into this for more than 10 years at The Queen Elizabeth Hospital and it is almost entirely seen in women after the age of about 40 to 50,” he said.

“It is an inflammatory response to sudden adrenaline rush, which was once used as a sudden booster to escape danger but now in some older women sets off an inflammatory response in the heart that can kill.

“We have seen it before with natural disasters – there were about 20 cases after the Christchurch earthquake.

“I am concerned with … the wider national health implications of the bushfires.”

Prof Horowitz said symptoms included chest pain but could also be more vague, such as simply feeling faint. This was why it could be mistreated as heat exhaustion.

He urged health and emergency authorities to be alert for older women who appeared to be suffering heat stress but could actually be victims of the syndrome.

A routine blood test for heart problems – which normally checked for blocked arteries – would also point to the inflammation. “We’ve got plenty of extremely hot days ahead,” Prof Horowitz said.

Dr Angela Kucia, an expert in the syndrome who lectures at UniSA and is an acute cardiac assessor at Lyell McEwin Hospital, said last year’s heat wave also triggered a sudden spike in cases and there is published evidence of surges during extreme heat.

“We know about a third of cases have an emotional trigger, a third a physical trigger like heatwaves but a third are unknown,” she said.

“People including families of older women need to know that being faint or dizzy may be an indicator and not just write it off as heat stress.” See www.takotsubo.net.