Chapter 1: What causes a broken heart according to cardiologist Sandeep Jauhar?
Rare earths have become a powerful political tool for China. But before that, one U.S. company monopolized the industry. We have the dramatic story of how America dominated the market for rare earths and then lost it all. I think about that almost every day of my life, Kenny. What could I have done differently? Listen to Planet Money on the NPR app or wherever you get your podcasts.
This year. I literally feel like I'm a different person. Yes.
Chapter 2: How does grief physically affect the heart?
Do you feel that way? Ideas worth spreading. From TED and NPR. I'm Manoush Zomorodi, and today we are starting the show with a case of heartbreak.
A patient of mine was admitted to the hospital, and weeks prior, her husband had died, and And a couple of weeks after the funeral, she took a look at his picture and all these emotions came back, flooded back. Sadness, the grief over their life together.
This is cardiologist Sandeep Jahar.
She developed chest pain. And she got short of breath.
Chapter 3: What is Takotsubo cardiomyopathy or broken heart syndrome?
And by the time she was in the hospital, she had distended neck veins, water in her lungs. She was visibly panting. all signs of congestive heart failure. So we suspected that she had actually had a heart attack, that she had blockages in the arteries that feed her heart. But when we checked with a angiogram, her coronary arteries were pristine. It wasn't a hint of blockage anywhere.
But her heart had weakened to less than half its normal function. And it had a very unusual shape. And what we found was that it was the syndrome Takotsubo cardiomyopathy, or the broken heart syndrome.
Wait, what is that?
Chapter 4: How can emotional stress impact heart health?
Takotsubo is a special pot that's used in Japan to trap octopuses. And it has a sort of wide base and a very narrow neck. And that's exactly the way her heart looked on the ultrasound that we did. The base was constricted. The apex of the heart had ballooned out. into this distinctive shape.
Whoa, that is crazy. So her heart was like swollen. And this is what heartbreak can look like, literally.
Yeah.
Chapter 5: What role does communication play in preventing heartache in relationships?
So emotions and the responses that they engender can have a direct effect on the heart. And the heart can acutely weaken in response to a heartbreak or grief such as after the death of a loved one or the end of a romantic relationship. So we told her that very likely this would improve once her emotional state had returned to normal, and that's exactly what happened.
Once the grief had subsided and she came back to her baseline state, we repeated the ultrasound and her heart had returned to normal. So it's just a fascinating syndrome. We too often think of The emotional aspects of the heart is purely metaphorical or symbolic, but emotions can have a direct disruptive effect on the heart. And there really is such a thing as heartbreak.
The average human heart beats nearly 3 billion times over the course of a life.
Chapter 6: How can couples address potential issues before they arise?
But when stress, fear, or sadness weigh on us, the heart can suffer, sometimes even break. There are, however, ways we can mend it. And so today on the show, stories and ideas about soothing heartache. From the connection between our emotions and our health to protecting our romantic relationships and facing our anxiety about the future. We'll explore ways we can nurture our most vital organ.
Sandeep Jahar's fixation on the heart stems back to his family history and a story about his grandfather from 1953, before Sandeep was even born.
It was a summer day in July. My grandfather was working in a tiny shop in Kanpur, which was a rural community in North India, and he was bitten by a snake. Now, snakebite is fairly common in India. And when my grandfather came home for lunch, he was feeling fine.
Chapter 7: What insights does pediatric nurse Weiwen Sato share about coping with grief?
But some neighbors brought in the snake that they claimed had bitten my grandfather. And it was a shiny black cobra. And my grandfather took one look at it and he slumped to the floor and died.
At the hospital, a doctor pronounced him dead on arrival and said that it wasn't a snake bite that killed my grandfather, but it was a heart attack, probably induced by the sudden sort of tremendous fright of looking at the snake that had bitten him and the fear that he was not going to be able to survive the snake bite.
So it's not just grief or romantic heartache that can affect our hearts. It can be any really extreme emotion.
Right.
Was this a story that you heard a lot when you were growing up?
Yeah. That event was profoundly tragic in our family.
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Chapter 8: How can we find hope amidst environmental heartache?
And I sort of grew up with this fear that something would happen to my own father. And that... fear translated into sort of an obsession. I remember I would lie in bed and sort of monitor the thudding of my heart in my chest. I would look up at the ceiling fan that was rotating and try to synchronize the rotations of the blades with my heartbeat. And I sort of became obsessed with
this sort of dichotomous nature of the heart that it was constantly moving and yet so vulnerable and in the process made us vulnerable. In other words, there was such a thing as sudden death. And the fact is that sudden death almost always occurs because of the cessation of the heartbeat.
Here's Sandeep Jahar on the TED stage.
Heart syndromes, including sudden death, have long been reported in individuals experiencing intense emotional disturbance or turmoil in their metaphorical hearts.
In 1942, the Harvard physiologist Walter Cannon published a paper called Voodoo Death, in which he described cases of death from fright in people who believed they had been cursed, such as by a witch doctor or as a consequence of eating taboo fruit. In many cases, the victim, all hope lost, dropped dead on the spot.
What these cases had in common was the victim's absolute belief that there was an external force that could cause their demise and against which they were powerless to fight. This perceived lack of control, Cannon postulated, resulted in an unmitigated physiological response in which blood vessels constricted to such a degree
that blood volume acutely dropped, blood pressure plummeted, the heart acutely weakened, and massive organ damage resulted from a lack of transported oxygen. Today, death by grief has been seen in spouses and in siblings. Broken hearts are literally and figuratively deadly.
You know, Sandeep, I think we hear a lot these days about how stress is bad for us. It's bad for our health. But do you feel like people just don't take that seriously enough or they don't understand the stakes of like how much stress and emotions are connected to our physical well-being?
Yeah. You know, the American Heart Association for the longest time did not list psychosocial stress as a key modifiable risk factor. for heart disease. Now, why is that? I think the reason is that it's so much easier to lower blood pressure than it is to lower emotional stress.
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