University of Hawaii medical student Stephen Chun has co-authored a medical paper on a heart pacemaker case.
Mending a Broken Heart
A UH medical student sheds light on a cardiac condition that is linked to pacemakers
University of Hawaii medical student Stephen Chun found a Hawaii patient suffering from "Broken Heart Syndrome," but the ailment wasn't triggered by a broken heart.
It was triggered by a pacemaker implantation.
Chun was in Japan this summer for a medical education program and learned about a condition called the "Broken Heart Syndrome."
"They said it usually only happens in Japan," said Chun, in his second year at the John A. Burns School of Medicine. "It's a very interesting thing that happens because of emotional distress."
Symptoms include chest pain and other signs of a heart attack, but no clogged arteries, he said.
A medical paper on the pacemaker case has been accepted for publication in the International Journal of Cardiology. Co-authors with Chun are Drs. Derek Pang, cardiologist; Victor Kwok, internal medicine and geriatrics; and Thomas K. Lau, specialist in internal medicine, oncology and gastrointerology.
"Sure enough, one of the first patients when I got back to Honolulu had this syndrome," Chun said.
The patient was a 77-year-old native Hawaiian woman with a pacemaker implantation.
"She had really low heart rate. The body was pumping out adrenaline to increase the heart rate."
The disease is caused by excessive adrenaline, according to most literature, said Chun, a graduate of Punahou School and Georgetown University.
He believes the pacemaker was documented as the cause of a case in Japan, but said this was the first case reported from a pacemaker implantation in the United States.
Chun said the paper's authors want to get information out about the syndrome because a patient mistakenly identified with a heart attack could be given anti-clotting medication that could cause severe bleeding.
"If it is recognized, since there are no blocked arteries, the literature indicates anticoagulants shouldn't be administered," he said.
But the condition is very rare and "the likelihood is very low you would die," Chun said.
He said he feels "pretty lucky" to recognize the symptoms while assisting with an examination at St. Francis Medical Center as part of a required course in clinical skills.
Earlier in the summer, he had studied case histories of "Broken Heart Syndrome," formally called "Takotsubo cardiomyopathy," while in Japan with the UH Program for Medical Education in East Asia.
The syndrome was first detected in Japan in the 1990s and for a long time was believed to occur only in Japanese women, Chun said. Then the condition was reported in Denmark in 2003 and in the United States in 2004, he said.
In most cases, it is caused by the death of a loved one, but it has been attributed to earthquakes in Japan and to surprise parties, Chun said.
The patient has all the signs of a heart attack, except there are no clogged arteries and it reverses itself in three weeks, he said. "It's really fascinating the way this thing will reverse in three weeks."
That happened with his patient and she is fine now, he said.