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Can a Broken Heart Cause a Broken Heart?

Broken Heart

A person's risk of suffering a heart attack increases by approximately 21 times in the first 24 hours after losing a loved one, slowly declining over the course of a month, according to a study published by Beth Israel Deaconess Medical Center researchers.

The study published online in the journal Circulation found the risk of heart attack remained eight times above normal during the first week after the death of a loved one, before steadily declining over the course of a month.

Researchers interviewed approximately 2,000 patients who suffered myocardial infarctions, or heart attacks, over a five-year period. Patients were asked a series of questions about potentially triggering events, including losing someone close to them in the past year. Previous research has acknowledged Takotsubo cardiomyopathy, often referred to as "broken heart syndrome."

Murray A. Mittleman, MD"The 'broken heart' leads to physiologic changes, including things like changes in heart rate and blood pressure, and the coaguability (of blood) … which all together can increase the risk of a heart attack," said senior author Murray Mittleman, MD, DrPH, a physician in the CardioVascular Institute at BIDMC.

While there is widespread anecdotal evidence that the death of a loved one can lead to declining health in survivors, few studies have looked at the acute effect of bereavement and grief on myocardial infarction.

"Bereavement and grief are associated with increased feelings of depression, anxiety and anger, and those have been shown to be associated with increases in heart rate and blood pressure, which can lead to a heart attack," said lead author Elizabeth Mostofsky, MPH, a post-doctoral fellow in the Cardiovascular Epidemiological Unit at BIDMC.

Family members should be aware of this heightened risk and provide support to help the individual deal with grief and take care of him or herself.

Physicians should closely monitor patient in the days and weeks following the loss and deliver proper evaluation and care.

This study was funded by the National Institutes of Health .

Welcoming Milton

Beth Israel Deaconess Hospital-Milton

After a successful eight-year affiliation, Milton Hospital is now officially part of the BIDMC family. The new Beth Israel Deaconess Hospital-Milton offers even better coordination of care to those in the community.

The new agreement, which took effect on January 1, is resulting in better coordination of care and services through shared electronic medical information and coordinated clinical and programming. BIDMC will work more closely with Milton to identify opportunities to enhance the services available locally to patients. Patients with complex medical needs who require tertiary care or specialty services unavailable in Milton will have a smooth access to caregivers and services at BIDMC.

"Over the past eight years, Milton's association with BIDMC has allowed us to expand services and strengthen the quality of care we deliver," said Joseph V. Morrissey, CEO of Milton Hospital. "This new agreement cements the already-strong commitment between the two hospitals. It allows Milton to become part of BIDMC's large health care delivery system ensuring that patients in Milton and the neighboring communities of Quincy, Randolph, Canton, Hyde Park and Dorchester, where Milton Hospital has served residents for the past 108 years, will continue to receive the very best care available."

"We are pleased by the opportunity to formalize our work with this excellent community hospital," said Kevin Tabb, MD, President and CEO of BIDMC. "Our expanded relationship with Milton strengthens our community network, and is fundamental to our long-standing philosophy to provide care in the right place at the right time."

In 2003, BIDMC and Milton began collaborating on geriatric services and the development of the Cardiac Rapid Transfer program, which provides emergency cardiac access in the community for patients undergoing coronary angiography, angioplasty, stent placement and other cardiac procedures.

Cardiologists at both hospitals use joint protocols and procedures for patient care to ensure a smooth transition from the community to tertiary setting as needed.

Harvard Medical Faculty Physicians (HMFP) at BIDMC operates the Emergency Department at BID-Milton. The hospitals also have strong existing relationships in hospitalist services, cardiovascular health, orthopedics, gynecology, prostate health and geriatrics.

To learn more about Beth Israel Deaconess Hospital-Milton, click here .

Colds & Vitamin C Supplements

Vitamin C supplements

With cold and flu season upon us, it may be tempting to reach for one of the products that offer a blast of Vitamin C, but it's better for your overall health to reach for a piece of fruit instead.

"We get a tickle in our throat and then we wonder, 'What can I do to make this better?'" said Elisabeth Moore, a registered dietitian at Beth Israel Deaconess Medical Center.

People may view supplements such as Airborne and Emergen-C as a quick and easy fix; each contains 1,000 mg of Vitamin C along with other vitamins and minerals.

But, Moore said, "I don't recommend Vitamin C in high doses. I'd rather see people get it through the food they're eating or through multivitamins."

For years, Vitamin C has been seen as a remedy for the common cold, but research shows that for most people, Vitamin C supplements or Vitamin-C rich foods do not reduce the risk of getting a cold.

Dr. George Blackburn, Chief of the Nutrition/Metabolism Laboratory at BIDMC, agrees.

"Treating a cold with Vitamin C supplements is misdirected effort; whereas rest, fluids and a healthy diet will provide all the Vitamin C needed and provide the most effective and rapid recovery," he says.

However, people who take Vitamin C supplements regularly might have slightly shorter colds or somewhat milder symptoms when they do have a cold. Using Vitamin C supplements after cold symptoms start does not appear to be helpful.

The minimum daily requirement of Vitamin C for adults is 75 mg for women and 90 mg for men, with an extra 35 milligrams needed by smokers. According to Moore, "a significant amount more than that won't have a huge added benefit."

Vitamin C, also known as ascorbic acid, is a water-soluble nutrient that acts as an antioxidant, helping to protect cells from damage caused by free radicals (compounds that are formed when our bodies break down food or when we are exposed to tobacco smoke or radiation and air pollution). Vitamin C is also needed for the growth and repair of tissues in all parts of the body, and it helps the immune system work to protect the body from disease.

The body does not store Vitamin C, so it is important to eat foods containing it. Citrus fruits, such as oranges and grapefruit, along with their juices, have high amounts of Vitamin C; other fruits that have high amounts of Vitamin C include:

  • Cantaloupe
  • Kiwi fruit
  • Mango
  • Papaya
  • Pineapple
  • Strawberries, raspberries, blueberries, cranberries
  • Watermelon

Vegetables that have the highest amounts of vitamin C include:

  • Broccoli, Brussels sprouts, cauliflower
  • Green and red peppers
  • Spinach and other leafy greens
  • Sweet and white potatoes
  • Tomatoes and tomato juice
  • Winter squash

Moore says that most fruits and vegetables have some Vitamin C in them, so it's easy to get enough in our diets. Five servings a day of fruits and vegetables - or about 2 1/2 cups - averages out to between 200 to 250 mg of Vitamin C.

"Even if you eat half that, it would still be adequate," she says.

Because the body cannot store the vitamin, serious side effects of taking too much are rare, but taking more than 2,000 mg a day can cause diarrhea, nausea and stomach cramps. In addition, many vitamins or minerals in excessive amounts put a strain on the kidneys, because they must work to excrete it. Vitamin C deficiency, which can lead to scurvy, is rare in the United States (it can be prevented with as little as 10 mg of Vitamin C a day).

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted January 2012

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