In the first of its kind, an Israeli medical study has found a correlation between so-called “broken heart syndrome” and national trauma, showing a 100% increase of cases since October 7. The research was presented earlier this month at Israelis Cardiology Association Conference.
The research was carried out under the leadership of Prof. Eli Lev, director of cardiology, and Dr Yuhavl Kahila at Assuta Hospital in Ashdod and involved collaboration with centers across the country, including Barzilai Hospital in Ashkelon, Hillel Yaffe Medical Center in Hadera, Shamir Medical Center in Be’er Ya’akov, Wolfson Medical Center in Holon and Meir Medical Center in Kfar Saba.
Broken heart syndrome, sometimes called Takotsubo cardiomyopathy, is a rare medical condition that can be triggered by intense distress or emotional suffering. It typically occurs in women. Symptoms may present like a heart attack, but the syndrome only accounts for about 2% of cases of people treated for heart attacks.
It is typically temporary, according to research, and usually gets better within a few months.
Post-October 7
In the weeks following October 7, Barzilai Hospital in Ashkelon recorded five cases, up from one in the same period in 2022.
Prof Lev said: "The increase was close to double across the country. The hypothesis is that the extreme mental stress [of the October 7 events] resulted in an increase in the syndrome among all residents of the State of Israel."
In addition, while usually only one-fifth of patients have heart failure-like complications, Barzilai doctors noted an increase of up to 66% in severe cases.
Using data from six hospitals across Israel, the research team recorded 30 cases between October and December 2023, up from 16 the year before.
This is a syndrome that simulates a heart attack caused by mental or physical stress," explained Prof. Lev, "and this is the first time that we see a clear connection between the syndrome and a national trauma - and the fact that the data in the study was collected all over the country and not just from the South shows this."
"So far, most patients' descriptions of the 'broken heart syndrome' have been reported following personal crises such as the death of a relative and other difficult events, and I am not aware of a description in the professional literature of the syndrome following a national trauma,” said the Professor.
"The syndrome manifests itself in a significant disturbance in the contraction of the heart muscle on an echocardiogram and can have significant complication and mortality rates," said Dr. Yuval Kahila.
The Chairman of Israel Heart Society, Amit Segev, told Hebrew media that he was not surprised by the findings.
"Broken heart syndrome is related to an increase in stress, and in all kinds of situations where there is an increase in stress, it is expected that there will be an increase in this syndrome," Segev explained. "For example, following the earthquake in California, they saw a huge increase in heart attacks, some of which were broken heart syndrome."
Case studies
In November, the Hillel Yaffe Medical Center reported an increase in women around the age of 50, mostly mothers of soldiers, who were suffering from symptoms of a heart attack.
In one case, a 49-year-old mother of three sons from Hadera was brought into hospital with severe symptoms. Two of her sons were called to fight in the South. She fainted at work but did not see it as a concern. However, a few days later, she received a message that her son’s commander had been injured severely in Gaza.
She reported an accelerated heartbeat, shaking in her knees, and then loss of consciousness. After arriving at Hillel Yaffe Medical Center by ambulance, the doctors discovered that her heart arteries were normal and she was actually suffering from "broken heart syndrome."
In another case included in the study, 40 year old IDF bereavement officer Capt. (res.) Sivan Sekeli Ben Zichri went into a stress-induced cardiac arrest upon witnessing 17 freshly dug graves at a funeral.
Ben Zichri was responsible for delivering news of the fallen to families and organizing funerals.
Despite a normal EKG reading at the hospital, she went into full cardiac arrest and was technically dead until successfully resuscitated. Doctors discovered she had a torn heart artery, which she was told was due to stress.
"The eulogies were so difficult that my heart simply could not cope," she said.
She has not yet recovered and is still undergoing rehabilitation.
In October, Israeli media reported that ZAKA volunteer Motti Botzkin suffered a stress-induced heart attack following a long and traumatic search for human remains in Gaza border communities.
Father of rescued hostage
While not officially diagnosed as such, relatives of Yossi Meir, father of rescued hostage Almog Meir Jan, have attributed his death, the night before he could hear of his son's return, to grief.
“The night before Almog’s return [to my brother], his heart stopped,” Meir’s sister Dina told KAN News.
Rabbi Lior Engelman, a friend of Meir, told Israeli media outlets: “Yossi loved Almog with all his heart and was tormented daily. His heart could not stand it.”
The daughter of released hostage Hannah Katzir also spoke of her mother's heart-related medical issues, stating that she, too, had "broken heart syndrome."
More on the condition
A 2007 study, presented in the Cleveland Clinic Journal of Medicine, wrote that the syndrome was referred to as stress cardiomyopathy in a study in 2005, but "because several of the patients had presented following the death of a loved one, the name “broken heart syndrome” was also introduced".
It continued by saying that 88.8% of the reported cases were in women, with an average age of 58 to 77. This remains consistent to this day.
The in-hospital mortality of 'broken heart syndrome' was around 1.1% at the time of the study.
Interestingly, the connection between Israel and the condition has been made before. A 2014 BBC article wrote of a 1995 research that found that "Israelis were more likely to die as a result of heart-related problems on 18 January 1991 than on any day in the preceding and subsequent two months, as well as for the same period of time the previous year."
This was because this date marked the beginning of the Gulf War, said the BBC, which resulted in 18 missiles being directed at Israel from Iraq.