Can Food Break Your Heart?

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ImageSource: © Shutterstock

Have you ever confused coriander with parsley? Or avocado with wasabi?
Green foods can disguise to perplex the brain.

This happened with a 60-year-old Israeli woman who was happily attending a wedding when she mistook wasabi for avocado, maybe due to her ravenous hunger. Large consumption of wasabi twisted the scene. Within a few minutes, she suddenly developed acute chest pain radiating to her arms.

She was hospitalised the following day. Complete examination and tests were conducted and she was diagnosed with ‘Takotsubo cardiomyopathy’ or ‘Broken heart syndrome’. The latter name is attributable to its usual triggers: emotional stress or physical exertion. She was treated with ACE inhibitors and beta-blockers. A complete recovery was seen during the next follow-up.

What was the triggering factor in the woman in the discussion here? She was at a wedding party!
Everything was good until she ingested wasabi. If you are a sushi lover, you may be aware of wasabi’s spicy taste, as it is usually served with sushi to add flavour.
Here the culprit is the super spicy stimulus from wasabi which flooded the stress pathways leading to acute chest pain.

Takotsubo cardiomyopathy (TCM) is primarily characterized by reversible and transient left ventricular (LV) ballooning. Coronary arteries remain normal. It is seen more commonly in postmenopausal elderly, white women (indicating some role of estrogen in the aetiology). After a triggering event, transient hypokinesis of the left ventricular (LV) apex occurs but this wall motion abnormality resolves within a few days to weeks.

Symptoms of broken heart syndrome resemble that of a heart attack – angina, palpitations, shortness of breath, etc, then what’s the difference between the two?

Heart attack causes permanent damage, whereas the dysfunction due to broken heart syndrome is temporary. Usually, patients make full recovery in a month.

Treatment is symptomatic with adrenergic blockade being the primary goal. In practice, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) are given until the left ventricular function is restored. β-blocker, α-adrenoceptor agonist or calcium channel blockers can be considered.

Although the prognosis is good, yet some complications may ensue such as hypotension, heart failure, ventricular rupture, etc.

Interesting Fact:
The name takotsubo cardiomyopathy has a Japanese origin. In Japanese ‘takotsubo’ means a fish pot which has a narrow neck and a round bottom. Heart affected with TCM acquires this shape as seen during systole on ventriculography, hence the name.

Image Source: AHA Journals ©
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Dr. Arsia Parekh
Dr. Arsia Hanif has been a meritorious Healthcare professional with a proven track record throughout her academic life securing first position in her MCAT examination and then, in 2017, she successfully completed her Bachelors of Medicine and Surgery from Dow University of Health Sciences. She has had the opportunity to apply her theoretical knowledge to the real-life scenarios, as a House Officer (HO) serving at Civil Hospital. Whilst working at the Civil Hospital, she discovered that nothing satisfies her more than helping other humans in need and since then has made a commitment to implement her expertise in the field of medicine to cure the sick and regain the state of health and well-being. Being a Doctor is exactly what you’d think it’s like. She is the colleague at work that everyone wants to know but nobody wants to be. If you want to get something done, you approach her – everyone knows that! She is currently studying with Medical Council of Canada and aspires to be a leading Neurologist someday. Alongside, she has taken up medical writing to exercise her skills of delivering comprehensible version of the otherwise difficult medical literature. Her breaks comprise either of swimming, volunteering services at a Medical Camp or spending time with family.

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