The prostate gland has two important functions: To produce
ejaculatory fluid and to act as a barrier to retrograde UTIs. Prostate
enlargement, or benign prostatic hyperplasia (BPH), can produce a
constellation of unpleasant symptoms that result when the enlarged gland
forces the bladder to work harder to expel urine. The prostatic
obstruction is both anatomic (compression of the urethra) and dynamic
(increased muscle tone of the prostate and bladder neck). Primary-care
nurse practitioners and physician assistants are in an ideal position to
recognize and evaluate the symptoms of BPH, review the differential
diagnoses, recommend treatment, refer patients as necessary, and ensure
follow-up. The Clinical Advisor spoke to Richard J. Macchia, MD,
chair of the Department of Urology and a Distinguished Teaching
Professor at the SUNY Downstate Medical School in Brooklyn, N.Y., and Ivan Rothman, ARNP, an
NP with urology certification at the University of Washington Medical
Center Urology Clinic and faculty member at the University of Washington
School of Nursing in Seattle. Both clinicians have expertise in BPH,
which affects nearly 50% of men aged 50 years and older.
Q: Who is most likely to get BPH?
Dr. Macchia: Any man is susceptible, but with age, an enlarged prostate becomes more and more likely.
Mr. Rothman: Generally, men diagnosed with BPH are older than 40.
Q: Which symptoms besides frequent urination should alert primary-care providers (PCPs) to the possibility of BPH?
Mr. Rothman: Be on the lookout for any kind of voiding problem.
The two main types are irritative and obstructive. Irritative refers to
frequency and urgency, and obstructive refers to difficulty starting,
slow stream, and post-void dribbling. Waking up at night can be a
problem in and of itself and is always worth evaluating. The best
office-based diagnostic tools are the symptoms and the score on the
American Urological Association (AUA) Symptom Index (SI) (available at www.auanet.org/guidelines/main_reports/bph_management/chapt_1_appendix.pdf, accessed July 8, 2008). This is a well-validated paper-and-pencil screening tool.
Dr. Macchia: Getting the AUA SI score is something any
primary-care clinician can do. The patient answers seven
self-administered questions about complete voiding, frequency, stopping
and starting, urgency, weak stream, straining, and nocturia. Severity of
symptoms is quantified by rating each on a scale of 0-5. A man with no
symptoms would score 0, and a man with all the symptoms at maximum
severity would score 35. When a patient comes to me with lower urinary
tract symptoms (LUTS), I ask him to fill out the AUA SI. Any abnormality
of urination should trigger the AUA inventory. The International
Prostate Symptom Score is similar to the AUA SI.
In addition, ask patients about their “bother” factor: Two patients may
have the same symptoms, but one will say, “We have to do something about
this; it's driving me crazy,” while the other will tell you it's not a
problem.
When patients complain of symptoms, be sure to obtain a complete history
because there are many nonurologic causes of LUTS (e.g.,
diverticulitis). Basically, any pathology in the pelvis can present as
LUTS. There is no substitute for a thorough history. Instruct patients
to bring in all their medications. It is very difficult to care for
patients without knowing what they are taking. What was listed in your
notes three months ago is ancient history. In my experience, 30% of
patients who state they are on the same medications as at the last
office visit are, in fact, not.
After taking the patient's history, I conduct a physical examination
with emphasis on the genitalia and prostate. The primary purpose of
digital rectal examination (DRE) is to search for any lumps and bumps
and to estimate the size of the prostate.
Q: Besides doing a DRE for an enlarged prostate, are there any other office-based diagnostic steps that can be taken?
Mr. Rothman: I always evaluate patients with voiding problems for
infection and malignancy. With UTI, look for RBCs, WBCs, and bacteria in
the urine. For malignancy, look for hematuria (RBCs).
Dr. Macchia: Dipsticks can be overly sensitive and give
false positives for hematuria. I prefer the full urinalysis with
microscopic examination, which can show the presence or absence of RBCs,
WBCs, bacteria, fungi, and more. It is also important to know what
formed elements are in the urine. Formed elements may be an indication
that kidney disease is causing the hematuria.
Q: How often should prostate-specific antigen (PSA) be tested?
Dr. Macchia: After the history, the exam, and the full
urinalysis, I discuss with the patient the advisability of measuring his
PSA. Generally, I follow the AUA guidelines for PSA testing. It is
prudent to follow the guidelines of some national organization. The AUA
guidelines are fairly simple: If the patient is African American or has a
family history of prostate cancer, he should be getting an annual
prostate checkup starting at age 40. If he doesn't fall into either
category, start at age 50. While PSA-based true population screening is
controversial, what you do in your office with a given patient is
straightforward. Failure to discuss the pros and cons of PSA testing
with a patient can have unpleasant medical and legal repercussions.
Mr. Rothman: The value of the PSA test is keenly
debated. PSA recommendations, which were due to be released by a
subcommittee of the AUA in May 2008, have been delayed while members
sort through the considerations. Of course, you look at the PSA to
screen for prostate cancer. There is no reason you would use it to
evaluate voiding dysfunction per se.
Q: When do you order ultrasound or x-rays?
Dr. Macchia: In patients with bothersome or high-score
LUTS, I do a simple in-office sonogram to determine whether or not the
patient has a significant amount of postvoid residual urine (PVR). In an
adult male, we would like to see PVR <100 a="" an="" and="" aua="" biopsy.="" br="" bump="" can="" cc.="" conjunction="" considerable="" diagnosis="" doesn="" either="" elevation="" found="" general="" give="" in="" information="" is="" it="" lead="" lump="" misery.="" more="" nobody="" obtain="" of="" only="" or="" performed="" prostate.="" prostate="" psa="" pvr="" score="" should="" si="" similar="" sonogram="" t="" testing="" that="" the="" there="" to="" unindicated="" unless="" with="" you="">
But some clinicians are ordering prostate sonograms routinely, and like all other tests, sonograms have false positives.
Mr. Rothman: Nonspecific, hypoechoic lesions that are
indistinguishable from prostate cancer may show up on prostate
ultrasound. One should be wary of ordering prostate ultrasound in men
older than 40 without a biopsy. 100>
Q: What signs or symptoms warrant referral to a urologist?
Mr. Rothman: You should refer if the patient has blood
in the urine and needs a workup for malignancy. Also refer if one or two
attempts at drug therapy have not controlled voiding symptoms to the
patient's satisfaction.
Dr. Macchia: Refer any patient with LUTS for which you do not have a
specific diagnosis, LUTS you cannot eliminate, an abnormal PSA (based on
whatever criteria you use), any abnormality on the rectal exam
(especially a lump or bump), or hematuria.
Q: What medications are available?
Dr. Macchia: If you think it is likely that the patient
has bothersome LUTS or a large PVR attributable to BPH, the first step
is to treat with medication. The most commonly prescribed drugs are the
alpha blockers tamsulosin (Flomax) and alfuzosin (Uroxatral). I also use
the alpha blockers doxazosin (Cardura) and terazosin (Hytrin). By
reducing the dynamic outflow obstruction, the strength of the urinary
stream can be immediately improved, as can the PVR. Irritability of the
bladder can also be decreased over time. One needs to look at both the
approved and commonly used off-label dosages for the alpha blockers. I
often use higher-than-approved doses of alpha blockers in an attempt to
avoid surgery, especially in patients with multiple conditions that
raise the risk of morbidity. You must document and advise the patient
whenever any medication is used in an off-label manner.
If the prostate is more dramatically enlarged, you can simultaneously
start a 5a-reductase inhibitor (e.g., finasteride [Proscar] or
dutasteride [Avodart]), which shrinks the prostate. Be aware that these
drugs reduce PSA by 50% over time, and this must be taken into account
when using PSA to screen for cancer. You really want to max out the
pharmacologic therapy before referring for minimally invasive surgery.
Many drug companies have informational booklets, and I encourage passing
these on to patients.
Mr. Rothman: Alpha blockers are first-line therapy.
There is not enough evidence to say one is better than the others. I
start with the least expensive or most easily tolerated alpha blocker.
If that does not work, change to another one. If you use an alpha
blocker with a variable dose, increasing the dose is reasonable. It is
also reasonable to add a 5a-reductase inhibitor to an alpha blocker.
Most men with BPH are treated by primary-care providers. The AUA SI can
be used effectively for monitoring response to therapy. Occasionally,
when patients have severe irritative and obstructive symptoms, you may
want to add an anticholinergic drug. This is best done in consultation
with a urologist. As for nutraceutical supplements, I have seen one
study in favor of and one study opposed to saw palmetto. I still
recommend trying it; it's safe, easy to obtain, inexpensive, and
potentially helpful. It also may help the patient adjust to the idea
that he needs to take medication.
Sometimes symptoms of BPH occur in younger men who have never had
chronic illness. Patients with BPH need to understand that they have a
chronic illness, which needs treatment. The transition to prescription
medications can be easier if you start with something OTC.
Q: What lifestyle changes do you recommend?
Dr. Macchia: While there are pathologic conditions that
can cause nocturia and must be ruled out, the vast majority of cases
are attributable to BPH. I tell patients that when the bladder fills up,
they have to go to the bathroom whether it's in the middle of the day
or the middle of the night. If they don't want to get up at night, I
tell them to start restricting fluid intake four to six hours before
going to sleep. I say, “You have the other 18-20 hours of the day to
drink all you want.” If people drink fluids at night, especially if
they're already well hydrated, their kidneys will put out more and more
urine. Alcohol is a special case because it's a diuretic.
A heart-healthy lifestyle is probably good for the prostate. Supplements
and minerals are being vigorously promoted, with few data to support
their use. However, I recommend patients take a good men's daily
multivitamin tablet. Does it work? That's hard to say. The problem with
BPH is the 30% placebo rate. Sometimes BPH gets better on its own.
Mr. Rothman: Bus drivers, truck drivers, and airline
pilots delay voiding for very long periods of time. This causes the
bladder to stretch, become hypocontractile, and lose its ability to
function. More frequent urination, when possible, would be beneficial.
Quitting smoking will help reduce prostate size, though we're not sure what the underlying mechanism is.
Q: What are the consequences of untreated BPH?
Dr. Macchia: Some patients with minimal symptoms might have a
large PVR. I have had patients with more than 1,000 cc of residual urine
who had no pain or other symptoms. The bladder had become chronically
distended and desensitized. If that continues, the bladder loses its
compliance. The muscle then becomes more and more inefficient at pushing
out urine. Ultimately the muscle becomes a useless piece of tissue.
Mr. Rothman: Acute urinary retention has to be treated
with catheterization and frequently with surgery to reduce prostate
size. For patients with milder symptomatology though, there is no clear
evidence that early treatment will prevent future problems.
Q: What misconceptions about BPH do patients often bring to their PCP?
Dr. Macchia: Far too many patients believe they are
going to go back to urinating the way they did when they were in high
school. The prostate gland and urinary system get old just like
everything else. The symptoms of a vast majority of patients can be
improved but not totally eliminated. Also, patients frequently do not
realize that stress can cause urinary tract symptoms.
Q: What cautionary advice do you have for PCPs with regard to BPH diagnosis and treatment?
Dr. Macchia: It is a misconception that only enlarged prostates
cause problems and that an enlarged prostate always causes a problem. A
small prostate may lead to obstruction and a large one might not. Do
not assume LUTS are attributable to BPH or a UTI, and always be careful
to rule out a malignancy.
Ms. Lippert is a medical writer and editor in the New York City area.
Read On
* American Urological Association. Diagnosis of BPH. Available at: www.urologyhealth.org/adult/index.cfm?cat=09&topic=173, accessed July 8, 2008.
* American Urological Association. Management of BPH. Available at: www.auanet.org/guidelines/bph.cfm, accessed July 8, 2008.
* Cortlandt Forum. Benign prostatic hyperplasia: applying the guidelines to clinical practice. www.cortlandtforum.com/content/fileadmin/files
/Supplements/PDFs/BPH_CF.pdf, accessed July 8, 2008.
* http://www.clinicaladvisor.com/recognizing-symptoms-of-an-enlarged-prostate/article/120878/
"Because we seldom to talk about it.. Sometimes we do not worry... Because we are MEN lets talk about it!"
Wednesday, February 20, 2013
Sunday, February 10, 2013
DETERMINING WHEN MEN NEED TESTOSTERONE
Klinefelter syndrome is a genetic disorder and cause of primary hypogonadism. |
Men with testosterone deficiency have symptoms that are often underrecognized, underreported, or denied by the patient and the clinician alike. Some of the symptoms overlap with those of other chronic conditions, especially depression and fatigue. Key complaints that should lead to the suspicion of testosterone deficiency are changes in sexual function (especially a decline in erectile quality), libido, and ejaculate volume.3 Other symptoms include:
- Infertility
- Decrease in beard and body hair growth
- Increase in body fat
- Decrease in size or firmness of testicles
- Decrease in muscle mass
- Development of breast tissue (gynecomastia)
- Loss of bone mass (osteoporosis )
Other than aging, there are several other causes of testosterone deficiency in an adult male, and these are categorized as primary, secondary, or combined. Causes of primary hypogonadism include Klinefelter syndrome (a chromosome abnormality), undescended testes, injury to the testes, or testicular damage attributable to radiation or chemotherapy.
Secondary hypogonadism results from failure of the pituitary to produce enough follicle-stimulating hormone and luteinizing hormone to stimulate the testes. Common causes include obesity, stress, aging, recreational drug use, and pituitary lesions or other endocrine causes.
Combined hypogonadism exhibits characteristics of both primary and secondary causes and is commonly seen with cirrhosis, aging, and sickle cell disease.
Clinical exam
The clinician should first investigate possible causes of acquired testicular failure (e.g., mumps orchitis, trauma, radiation exposure, surgery, and chemotherapy). Inquire about both prescription and recreational drug use, since certain agents (e.g., spironolactone, marijuana, heroin, and methadone) may interfere with testosterone synthesis. Establish whether there is a history of paternity—an indicator that at some point in the past, the testosterone level likely was normal.The diagnosis of testosterone deficiency is based on examination findings and a test of the serum testosterone levels. Specific issues to consider in the physical exam include developmental anomalies in the genital system. Examine the genitalia for hypospadias (a congenital opening of the urethra on the undersurface of the penis), and check the scrotum for signs of cryptorchidism (undescended testes). Determine whether both testes are palpable, their position in the scrotum, and their consistency and size. Examine for signs of Klinefelter syndrome, such as tall stature (especially if the legs are disproportionately long), small or soft testes, and a eunuchoid body status, although many patients will not demonstrate a “typical” Klinefelter habitus. Finally, evaluate the extent of body virilization. Inquire about the rate of beard growth, libido and sexual function, muscle strength, and energy levels. Check for gynecomastia. The physical examination is typically unhelpful in making the diagnosis of testosterone deficiency, except in cases of profound and long-term hypogonadism.
http://www.clinicaladvisor.com/determining-when-men-need-testosterone/article/139598/
Sunday, February 3, 2013
FACT, PRESUMPTIONS and MYTHS of Obesity
What really causes Obesity?. Do you know someone who are obese and they believed that it has something to do with their genes? Or eating food with high in calorie content contribute to that obesity?. Mass media including the use of world wide web, social network, contribute to rapid dissemination of information regarding obesity, but what is the fact of obesity that is supported by science and what are these myths and presumptions regarding obesity? Many held belief about obesity are found to be not supported by science as suggested in the review of literature posted in The New England Journal of Medicine
According to Krista Casazza, PhD, RD from University of Alabama at Birmingham and colleagues, We define myths as beliefs held to be true despite substantial refuting
evidence, presumptions as beliefs held to be true for which convincing
evidence does not yet confirm or disprove their truth, and facts as
propositions backed by sufficient evidence to consider them empirically
proved for practical purposes.
Myths
We review seven myths about obesity, along with the refuting evidence. Seven Myths about Obesity. provides anecdotal support that the beliefs are widely held or stated, in addition to reasons that support conjecture.
1. Small Sustained Changes in Energy Intake or ExpenditureMyth number 1: Small sustained changes in energy intake or expenditure will produce large, long-term weight changes.
2. Setting Realistic Weight-Loss Goals
Myth number 2: Setting realistic goals for weight loss is important, because otherwise patients will become frustrated and lose less weight.
3. Rate of Weight Loss
Myth number 3: Large, rapid weight loss is associated with poorer long-term weight-loss outcomes, as compared with slow, gradual weight loss.
4. Diet Readiness
Myth number 4: It is important to assess the stage of change or diet readiness in order to help patients who request weight-loss treatment.
5. Importance of Physical Education
Myth number 5: Physical-education classes, in their current form, play an important role in reducing or preventing childhood obesity.
6. Breast-Feeding and Obesity
Myth number 6: Breast-feeding is protective against obesity.
7. Sexual Activity and Energy Expenditure
Myth number 7: A bout of sexual activity burns 100 to 300 kcal for each participant.
Presumptions
Just as it is
important to recognize that some widely held beliefs are myths so that
we may move beyond them, it is important to recognize presumptions,
which are widely accepted beliefs that have neither been proved nor
disproved, so that we may move forward to collect solid data to support
or refute them. Instead of attempting to comprehensively describe all
the data peripherally related to each of the six presumptions shown in Table 2Presumptions about Obesity., we describe the best evidence
1.Value of Breakfast
Presumption number 1: Regularly eating (versus skipping) breakfast is protective against obesity.
2. Early Childhood Habits and Weight
Presumption number 2: Early childhood is the period in which we learn exercise and eating habits that influence our weight throughout life.
3.Value of Fruits and Vegetables
Presumption number 3: Eating more fruits and vegetables will result in weight loss or less weight gain, regardless of whether any other changes to one's behavior or environment are made.
4. Weight Cycling and Mortality
Presumption number 4: Weight cycling (i.e., yo-yo dieting) is associated with increased mortality.
5. Snacking and Weight Gain
Presumption number 5: Snacking contributes to weight gain and obesity.
6. Built Environment and Obesity
Presumption number 6: The built environment, in terms of sidewalk and park availability, influences the incidence or prevalence of obesity.
Facts
Facts about Obesity.
lists nine such facts and their practical implications for public
health, policy, or clinical recommendations. The first two facts help
establish a framework in which intervention and preventive techniques
may work. The next four facts are more prescriptive, offering tools that
can be conveyed to the public as well established. The last three facts
are suited to clinical settings.
They contend that public health efforts to counteract weight-loss and obesity misconceptions and myths should focus on the following nine evidence-based facts:
1. Recognizing genes as a large contributor to obesity, but not one that cannot be overcome with sufficient environmental influence
2. The importance of lower caloric intake in weight management strategies
3. The positive effect of exercise on health
4. The necessity of sufficient exercise as a routine activity to maintain weight loss
5. The importance of involving parents and families in weight-loss and management strategies for overweight children
6. Incorporating structured meals and meal replacements as weight-loss aids
7. The utility of pharmacological agents in effective weight-loss strategies
8. Recognizing bariatric surgery as a viable option for long-term weight loss, and to decrease rates of incident diabetes and mortality
9.The role of genetics in obesity and that realistic changes to lifestyle and environment can lead to weight loss.
The researcher also acknowledge that the myths and presumptions about obesity that have discussed are just
a sampling of the numerous unsupported beliefs held by many people,
including academics, regulators, and journalists, as well as the general
public. Yet there are facts about obesity of which we may be reasonably
certain — facts that are useful today. While we work to generate
additional useful knowledge, we may in some cases justifiably move
forward with hypothesized, but not proved, strategies. However, as a
scientific community, we must always be open and honest with the public
about the state of our knowledge and should rigorously evaluate unproved
strategies.
______________________________________Source:
1. http://www.nejm.org/doi/full/10.1056/NEJMsa1208051#t=articleResults
(Myths, Presumptions, and Facts about Obesity)
2. http://www.clinicaladvisor.com/common-obesity-beliefs-often-unsupported-by-science/article/278306/ (Common obesity beliefs often unsupported by science)
Tuesday, January 29, 2013
TOMATOES MAY LOWER STROKE RISK IN MEN
HealthDay News-- Lycopene, an antioxidant found in high concentration in tomatoes and tomato products, may lower risk in men, study suggest.
Men who had high serum concentrations of the carotenoid had significantly lower risk for any stroke (HR=0.45;
95% CI: 0.25-0.95) and ischemic stroke (HR=0.41; 95% CI: 0.17-0.97),
compared with those who had low concentrations, Jouni Karppi, PhD, of
the University of Eastern Finland in Kuopio, and colleagues reported in Neurology.
The findings remained significant even after the researchers adjusted
for age, examination year, BMI, systolic BP, smoking, serum LDL
cholesterol, diabetes and history of stroke.
Results from previous studies examining the link between
carotenoid-rich food consumption and stroke risk have been mixed,
although some have shown associations between greater consumption,
higher serum levels and lower stroke risk.
To better understand these relationships, Karppi and colleagues
examined whether serum concentrations of major carotenoids correlated
with the risk of any stroke and ischemic stroke, among 1,031 Finnish men
aged 42 to 61 years, who were participating in the longitudinal Kuopio
Ischemic Heart Disease Risk Factor study.
Serum concentrations of lycopene, alpha-carotene, beta-carotene, alpha-tocopherol and retinol were measured.
During a median follow-up of 12.1 years, 67 strokes occurred,
including 50 ischemic strokes. After adjusting for confounding
variables, the researchers found that greater serum concentrations of
lycopene, but none of the other compounds, were associated with a lower
stroke risk.
The exceptional antioxidant properties of lycopene may help explain
why this carotenoid reduces stroke risk more than others, the
researchers suggested. "Lycopene is a potent antioxidant and the most
effective quencher of singlet oxygen, and it was reported to be more
effective than beta-carotene in cell protection against hydrogen
peroxide and nitrogen dioxide radicals."
Lycopene is also known to reduce inflammation, block cholesterol
synthesis, boost immune function, and inhibit platelet aggregation and
thrombosis.
"Results of the present study show that high serum concentrations of
lycopene, as a marker of intake of tomatoes and tomato-based products,
decrease the risk of any stroke and ischemic stroke in men," the
researchers wrote. "Thus, a balanced diet including fruits and
vegetables may prevent stroke."
References
- Karppi J et al. Neurology. 2012; 79: 1540-1547.
- http://www.clinicaladvisor.com/tomatoes-may-lower-stroke-risk-in-men/article/262763/
Sunday, January 20, 2013
The Pain of the Lost LOVE: BROKEN HEART SYNDROME
As mysterious as love may be, the agony of
its loss is an even more baffling experience, driving many men to depths of
despair they never knew existed. Now, however, researchers have begun to see
through our haze of pain, and understand that there's actually a method to our
sadness (The Science of Heartbreaks) Mens’Health.
What is more painful than someone’s
breaks your heart over the phone? I can’t even recall the banality that come
after hearing the sound of her voice.
The woman I’ve known intimately.
The woman I thought would be the mother of my child. I felt dissociated
and numb. Like the first time I had a motor accident were everything is blinded
by the incidence.
She just put down the phone after
her coup de grace. It was eve of Valentine’s Day, reservation for a dinner date
was made, flowers and chocolates are all set for delivery. Eventually, I caught myself standing in front
of the building and wandered the street an hour thinking it was the end of
everything.
Carol and I, we’ve met somewhere
in 2003 summer. Distracted and was I captured by beautiful innocent smile,
captivating smile, beautiful little chinita eyes, voluptuous body and long
black hair. Her beauty seized me I never
let that moment pass without knowing her name and telephone numbers.
I am broke, a broken hearted man.
So why does heartbreak hurt so badly? To answer that, you have to first
understand what you're really losing.
The flood of stress hormones accompanying
such events can weaken the heart. Researchers have discovered and dubbed the
phenomenon as Broken Heart Syndrome.
But even when the heart is not
literally broken, heartbreak can still
prove lethal in other ways. Rejected men kill
themselves at three to four times the rate that spurned women do. (The Science of Heartbreaks) Mens’Health.
WHAT IS BROKEN HEART SYNDROME or BHS?
Broken heart syndrome is a
temporary heart condition brought on by stressful situations, such as the death
of a loved one. People with broken heart syndrome may have sudden chest pain or
think they're having a heart attack. These broken heart syndrome symptoms may
be brought on by the heart's reaction to a surge of stress hormones. In broken
heart syndrome, a part of your heart temporarily enlarges and doesn't pump
well, while the remainder of the heart functions normally or with even more
forceful contractions.The condition was originally
called takotsubo cardiomyopathy. Today, it's also referred to as stress
cardiomyopathy, stress-induced cardiomyopathy or apical ballooning syndrome.
A study published in New England Journal of Medicine has found that sudden emotional stress can trigger a severe but reversible heart muscle weakness that mimics a heart attack. The condition had been labeled "stress cardiomyopathy" and has also been called "broken heart syndrome." The culprit appears to be adrenaline and similar "stress hormones" that over-stimulate the nervous system. (Feb 12 2005 Broken Heart syndrome Mimic Heart attack)
SYMPTOMS
Broken heart syndrome
symptoms can mimic a heart attack. Common symptoms include:
- Chest pain
- Shortness of breath
- An irregular heartbeat
- A generalized weakness
Any long-lasting or
persistent chest pain could be a sign of a heart attack, so it's important to
take it seriously and call the emergency hotline if you experience chest pain.
Prevention
There's a chance that
broken heart syndrome can happen again after a first episode. There's no proven
therapy to prevent additional episodes; however, many doctors recommend
long-term treatment with beta blockers or similar medications that block the
potentially damaging effects of stress hormones on the heart. Managing stress
in your life is also important.
WHAT BIBLE SAYS ABOUT BROKEN HEART?
Revelation 21:4
He will wipe away every tear from their
eyes, and death shall be no more, neither shall there be mourning, nor crying,
nor pain anymore, for the former things have passed away.”
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