Heart disease is often thought of as a problem that mainly affects men. In fact, men make up a large proportion of heart disease statistics around the world.
However, some heart conditions affect women more often than men. One of these conditions is called broken-heart syndrome, also known as takotsubo syndrome.
This condition can cause symptoms that look very similar to a heart attack, including chest pain, shortness of breath, and feelings of intense pressure in the chest.
Broken-heart syndrome is often triggered by extreme emotional or physical stress. A person may develop the condition after the death of a loved one, a serious argument, an accident, a frightening experience, or another highly stressful event.
Although the symptoms can be severe and frightening, doctors usually find no major blockage in the coronary arteries, which is different from a typical heart attack.
Another related condition is called MINOCA, which stands for myocardial infarction with non-obstructive coronary arteries. People with MINOCA also experience symptoms that resemble a heart attack but do not have obvious narrowing of the coronary arteries.
These patients often face uncertainty and worry because they have heart attack symptoms without a clear explanation.
Researchers have found that many people with these conditions experience high levels of stress and anxiety both before and after their illness. Despite this, there are currently no widely accepted treatment guidelines for providing psychological support to these patients.
To address this problem, researchers from Uppsala University and Karolinska Institutet in Sweden examined whether internet-based cognitive behavioral therapy, commonly known as CBT, could help. Their findings were published in the Journal of the American Heart Association.
CBT is a type of psychological treatment that helps people understand the connections between their thoughts, feelings, and behaviors. It teaches practical skills that can help people respond differently to stress and manage difficult emotions more effectively.
Internet-based CBT allows patients to receive treatment from home, making it easier for people who may have trouble attending regular therapy sessions.
The study involved 88 people who had recently experienced either broken-heart syndrome or MINOCA. The participants were recruited from hospitals in Stockholm, Orebro, and Ostersund shortly after their heart problems began.
Women made up 91 percent of the study participants. This reflects the fact that these conditions are more common in women and that women are often more willing to participate in psychological treatment studies.
The participants were divided into two groups. One group received standard care, while the other completed an internet-based CBT program along with two short telephone consultations with a psychologist.
The therapy lasted between seven and nine weeks and was specially designed with input from patients who had personal experience with these heart conditions.
Before and after treatment, researchers measured symptoms of stress and anxiety using several questionnaires.
The results were encouraging. Patients who received online CBT showed significant reductions in both stress and anxiety. The improvements were similar to those typically seen in many forms of psychological treatment.
Another positive finding was that very few people stopped participating in the program, suggesting that patients found the treatment useful and acceptable.
The researchers noticed something particularly interesting. Patients did not necessarily report feeling more capable of controlling stressful situations in their daily lives. Instead, they reacted less negatively to stress. In other words, they became better at handling the emotions that stressful situations created.
This finding is important because some life events cannot be changed. People cannot undo the death of a family member or erase a painful experience. However, they may be able to develop healthier ways of dealing with the emotions that follow such events.
The benefits of therapy were especially strong among patients with broken-heart syndrome. Among the 52 participants with this diagnosis, CBT appeared to work much better than standard care. The effects were smaller among the 36 patients with MINOCA.
The researchers believe several explanations are possible. People with broken-heart syndrome may have experienced long periods of stress and poor health before becoming ill and may therefore have a greater need for psychological support.
The study highlights an often-overlooked group of heart patients. Although men receive much attention in heart disease research, women also experience serious heart conditions that can be closely linked to emotional stress.
These findings suggest that psychological care should become an important part of treatment for patients with broken-heart syndrome and similar conditions.
The study has some limitations. It included a relatively small number of participants, and most of them were women. Larger studies will be needed to confirm the findings and determine exactly which parts of the therapy were most helpful.
Nevertheless, the results provide strong evidence that internet-based CBT can reduce stress and anxiety and help patients cope better emotionally after these frightening heart events.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about heart health, please see recent studies about how to remove plaques that cause heart attacks, and results showing a new way to prevent heart attacks, strokes.
Source: Uppsala University and Karolinska Institutet.
