The Real Cause of a Broken Heart?



The Heart of the Matter


The human heart is an amazing organ.  Over the centuries, the way we view it has changed.  It was once thought to be the seat of our emotions, the center of our being.  That notion gave way to that of the heart as merely a pump, although a grand pump to be sure.  With an average heart rate, the heart beats around 4,800 times per hour.  That’s an incredible 115, 200 times per day.  If you lived to be 80 years old, it would have beaten approximately 3,363,840,000 times without a rest (hopefully)– pumping over a million barrels of blood through a network of blood vessels that laid end to end, would circle the earth twice.


What the Heart Needs


As you can imagine, the energy requirements of the heart are enormous.  The average human heart is about the size of a clenched fist and weighs around 310 grams.1 The heart needs to generate a minimum of 6 kilograms – 20 times its own weight – of ATP per day.2   ATP is the universal energy currency of the body.  For heart cells to make ATP efficiently, they require nutrients and oxygen that are delivered via blood.  Patent blood vessels are required to carry said blood.


A Matter of Convention?


The most widely accepted theory of heart disease, greatly simplified, goes a little like this.  You have too much cholesterol floating around in your blood vessels.  Sometimes high blood pressure causes mechanical damage to your blood vessels or you experience inflammation damaging them.  Cholesterol collects in these damaged areas and, over time, these collections of cholesterol, called plaques, narrow the arteries and restrict blood flow to the tissues they serve. This narrowing continues until there is almost total blockage.  When the tissue’s need for blood flow outstrips the delivery, pain occurs.  Occasionally your blood clots at this narrowing or for some reason the plaque ruptures, resulting in a complete blockage of the artery.  The absence of blood flow to the area fed by that artery results in tissue death.  When this happens in the heart, it is called a myocardial infarction (MI) or a heart attack.


Nature’s Bypass


This process of arterial occlusion typically takes place over many years.  In the meantime, the body reroutes blood flow around these narrowing arteries via the growth of new blood vessels called collaterals.  If the occlusion proceeds gradually enough, sufficient collateral growth will allow total occlusion of the artery with little or no tissue subsequent damage.  Extreme cases have been reported where total occlusion of ALL the major coronary arteries have occurred, but extensive collateral circulation allowed for sufficient blood flow and normal heart function.   If there exist all these natural bypasses, how do heart attacks occur?

Can You Say Stress? 

Our nervous system has two main parts, the central and autonomic nervous systems.  The autonomic nervous system (ANS) can also be broken down into two main parts.  These are the parasympathetic (rest, digest, repair) branch and the sympathetic (fight or flight) branch. The ANS is in charge of bodily processes that don’t require our active management like breathing, heart rate and digestion.   In an optimal state, the parasympathetic branch is dominant and the sympathetic branch keeps a lower profile, ready to come on stronger if the need arises – like being chased by a serial killer or the like.


However, in our crazy, mixed-up world, we are under a constant barrage of stress – mental (finances, relationships, disasters, etc.) and physical (nutrient deficiencies, toxins, food sensitivities, heavy metals, etc.).  As a result, our parasympathetic branch isn’t working as well as it should and the sympathetic is a little overbearing.  Enter the proverbial straw that broke the camel’s back.  You experience one more physical or emotional stressor leading to further withdrawal of the parasympathetic and increased activity of the sympathetic.   This imbalance leads to significant changes in heart metabolism, resulting in a build up of acid in the heart muscle, impaired heart muscle function, stretching of the heart muscle, and compression of collateral vessels resulting in reduced or absent blood flow to an area already at risk.  BAM!! Call 911, because you’re having a heart attack.4


Stress isn’t just around for the final play.  It’s been there the whole season.  There is ample evidence that all kinds of stressors are involved in the development of the risk factors for heart disease like: high blood pressure, diabetes, and lipid abnormalities.6


HRV for You and for Me


My last blog post discussed Heart Rate Variability (HRV).  Please refer to it for a more detailed discussion.  In short, HRV is a measure of the health and functioning of your ANS.  It is a readily available, real-time parameter that has been studied and found to be predictive of acute events in heart disease. 6   It is also useful to provide biofeedback, guiding stress reduction/mitigation therapy. 

Reduced stress and/or a reduced response to it = reduced risk factors for heart disease and reduced progression of heart disease that’s already present.  


Stress Busters


Here are some ways to reduce stress and its effects:

·         Get 7-9 hours of sleep nightly

·         Eat a balanced, organic, whole-foods diet with plants as a foundation

·         Exercise regularly and move daily

·         Develop an attitude of gratitude (There is always something to be thankful for)

·         Prayer and meditation

·         Breathwork:  box breathing, 4-7-8 breathing, or alternate nostril breathing (See our video demo here)

·         Learn to say no and don’t overfill your plate

·         Take a walk in woods/nature

·         Consider Yoga, Tai Chi or an alternative like Praise Moves

·         Avoid isolation, connect, and “do” life with others

·         Use essential oils like lavender or chamomile

·         Earthing or Grounding


What are your favorite stress-relieving techniques?  Please let us know in the comments section below.










3.       Seiler C. Collateral Circulation of the Heart. London, UK: Springer-Verlag; 2009.




About the Author

Jason Gourlas, MPAS PA-C

For as long as he could remember, Jason has wanted to be a detective.  While serving as an Army medic, Jason realized that medicine combined detective work with his other love, science. He went through the Army PA program at Fort Sam while serving as a member of the Texas Army National Guard.  During his 22 + years in medicine, he has had a wide variety of experience in family practice, emergency medicine, neurotology (hearing and balance specialty), and surgical/trauma critical care.  For the last several years he has been studying and practicing functional and integrative medicine. He maintains certification in functional medicine through the American Academy of Anti-aging Medicine. 

About the Author

Jason Gourlas, MPAS PA-C

For as long as he could remember, Jason has wanted to be a detective.  While serving as an Army medic, Jason realized that medicine combined detective work with his other love, science.

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