BARRY'S BOOKS

New book in Dutch

Eet vet word slank

Eet vet word slank gepubliceerd januari 2013

In dit boek lees je o.a.: * heel veel informatie ter bevordering van je gezondheid; * hoe je door de juiste vetten te eten en te drinken kan afvallen; * hoe de overheid en de voedingsindustrie ons, uit financieel belang, verkeerd voorlichten; * dat je van bewerkte vetten ziek kan worden.

Trick and Treat:
How 'healthy eating' is making us ill
Trick and Treat cover

"A great book that shatters so many of the nutritional fantasies and fads of the last twenty years. Read it and prolong your life."
Clarissa Dickson Wright

Natural Health & Weight Loss
Natural Health & Weight Loss cover

"NH&WL may be the best non-technical book on diet ever written"
Joel Kauffman, PhD, Professor Emeritus, University of the Sciences, Philadelphia, PA


So You Can Die of a Broken Heart







Wittstein IS, David R. Thiemann DR. Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress. N Engl J Med 2005; 352; 539?548

ABSTRACT

Background Reversible left ventricular dysfunction precipitated by emotional stress has been reported, but the mechanism remains unknown.

Methods We evaluated 19 patients who presented with left ventricular dysfunction after sudden emotional stress. All patients underwent coronary angiography and serial echocardiography; five underwent endomyocardial biopsy. Plasma catecholamine levels in 13 patients with stress-related myocardial dysfunction were compared with those in 7 patients with Killip class III myocardial infarction.

Results The median age of patients with stress-induced cardiomyopathy was 63 years, and 95 percent were women. Clinical presentations included chest pain, pulmonary edema, and cardiogenic shock. Diffuse T-wave inversion and a prolonged QT interval occurred in most patients. Seventeen patients had mildly elevated serum troponin I levels, but only 1 of 19 had angiographic evidence of clinically significant coronary disease. Severe left ventricular dysfunction was present on admission (median ejection fraction, 0.20; interquartile range, 0.15 to 0.30) and rapidly resolved in all patients (ejection fraction at two to four weeks, 0.60; interquartile range, 0.55 to 0.65; P<0.001). Endomyocardial biopsy showed mononuclear infiltrates and contraction-band necrosis. Plasma catecholamine levels at presentation were markedly higher among patients with stress-induced cardiomyopathy than among those with Killip class III myocardial infarction (median epinephrine level, 1264 pg per milliliter [interquartile range, 916 to 1374] vs. 376 pg per milliliter [interquartile range, 275 to 476]; norepinephrine level, 2284 pg per milliliter [interquartile range, 1709 to 2910] vs. 1100 pg per milliliter [interquartile range, 914 to 1320]; and dopamine level, 111 pg per milliliter [interquartile range, 106 to 146] vs. 61 pg per milliliter [interquartile range, 46 to 77]; P<0.005 for all comparisons).

Conclusions Emotional stress can precipitate severe, reversible left ventricular dysfunction in patients without coronary disease. Exaggerated sympathetic stimulation is probably central to the cause of this syndrome.



COMMENT:

This study shows that experiencing extreme emotions can lead people to believe that they are having a heart attack.

Events such as a family death, car accident, fear of public speaking, or even a surprise party could trigger a condition called stress cardiomyopathy also known as "broken heart syndrome" – that mimics heart attack symptoms.

Lead investigator Dr Ilan Wittstein, from Johns Hopkins University School of Medicine in Baltimore, Maryland, explained: "After observing several cases of 'broken heart syndrome' at Hopkins hospitals – most of them in middle-aged or elderly women – we realised that these patients had clinical features quite different from typical cases of heart attack, and that something very different was happening.

"These cases were, initially, difficult to explain, because most of the patients were previously healthy and had few risk factors for heart disease."

Although the people had signs of a heart attack on measurements taken with an electrocardiogram machine, blood tests did not show typical signs of a heart attack, such as highly elevated levels of cardiac enzymes that are released into the bloodstream by damaged heart muscle.

A clue to the origin of the symptoms came from analysis of levels of chemicals such as adrenalin in the blood, which were far higher among emotionally stressed patients than in people diagnosed with a regular heart attack.

The good news is that all stressed patients showed signs of recovery within a few days, and complete recovery in 2-4 weeks.

"Our study should help physicians distinguish between stress cardiomyopathy and heart attacks," said Dr Wittstein. "And it should also reassure patients that they have not had permanent heart damage."

Nevertheless, as adrenalin is also raised in people who have stressful jobs, and who rush meals, I wonder how many "heart attacks" are being wrongly attributed to raised cholesterol or other heart "risk factors", and skewing the statistics?

Last updated 18 February 2005




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