Can you die of a broken heart?
人是否会因为伤心而死？
In 1986, a 44-year-old woman was admitted to Massachusetts General Hospital. She felt fine all day, but in the afternoon she developed extreme crushing pain in her chest, radiating through her left arm. It's a classic sign of a heart attack, but the puzzling thing was that she didn't suffer from coronary heart disesase. There was no life-threatening clot in the arteries surrounding the heart.
1986年，一位44岁的女士被送到马萨诸塞综合医院。她一整天都感觉良好，但下午却突然觉得极度胸闷，疼痛感甚至放射到左臂。这是典型的心脏病发作症状，但令人不解的是，她并未患有冠状动脉性心脏病。她心脏周围的血管里也没有危及生命的血栓。
It looked, from the outside, like a heart attack, but it wasn't. Describing the unusual case in the New England Journal of Medicine, Thomas Ryan, and John Fallon suggest the apparent damage to the heart muscle was emotional rather than physiological. Earlier that day, she had been informed that her 17-year-old son had committed suicide.
表面看来像是心脏病发作，但其实不是。托马斯·瑞恩(Thomas Ryan)和约翰·法伦(John Fallon)在《新英格兰医学期刊》(New England Journal of Medicine)上介绍了这个罕见病例。他们表示，这位病人的心肌明显受损，但这却是由情绪引起的，而非生理原因导致的。当天早些时候，这位女士刚刚得知她17岁的儿子自杀身亡。
Could the woman have suffered from a broken heart? The answer, it turned out, was already hiding in plain sight. The Massachusetts case was surprising to doctors – but it wasn’t news to everybody.
这位女士是否悲痛欲绝？答案已经显而易见。马萨诸塞州的这个病例令医生颇感意外——但并非所有人都会感到稀奇。
For many years, doctors scorned the idea of a relationship between psychology and physiology. In their book Zoobiquity, Kathryn Bowers and Barbara Natterson-Horowitz described this attitude: "Among many physicians, the idea that emotions could cause actual physical events within the architecture of the heart was viewed with nearly the same sideways glance as an interest in healing crystals or homeopathy. Real cardiologists concentrated on real problems you could see: arterial plaque, embolising blood clots, and rupturing aortas. Sensitivity was for psychiatrists."
多年以来，医生都对心理学与生理学之间的关系不屑一顾。凯瑟琳·鲍尔斯(Kathryn Bowers)和芭芭拉·内特森-霍洛维茨(Babara Natterson-Horowitz)就曾在他们合著的《Zoobiquity》一书中阐述过这种观点：“情绪能够导致心脏结构发生真实生理病变的观点会遭到很多医生的鄙视。在他们看来，这就像治疗水晶和顺势疗法一样不足为信。真正的心脏病学家会把精力集中在你能看到的实际问题上：动脉斑块、血栓和主动脉破裂。情绪是精神科医生的事情。”
Despite this, the evidence that extreme emotions can impact the heart goes back decades – only not among humans. It was wildlife biologists and veterinarians who first noticed that extreme emotions can wreak havoc on body physiology. By the mid-20th Century, they noticed that a curious thing happens when an animal experiences a sudden jolt of life-or-death fear. When it's caught by an advancing predator, adrenaline fills the bloodstream to such an extent that the blood almost becomes like a poison, damaging the animal's muscles, including the heart. It’s called “capture myopathy”.
尽管如此，关于极端情绪可能影响心脏的证据早在几十年前就已经出现——只不过并非来自人类。野生生物学家和兽医率先注意到，极端情绪可能对身体机能造成严重破坏。到20世纪中叶，他们发现，当动物突然经历生死攸关的恐惧时，会发生一些奇怪的事情。例如，被捕食者抓住后，动物血液中就会大量填充肾上腺素，几乎让血液变成毒液，对动物的肌肉构成破坏——其中也包括心肌。这种现象被称作“捕捉性肌病”(capture myopathy)。
By 1974, the effect was so well known to veterinarians that a letter in Nature proposing a possible way to avoid it didn't even bother explaining what it was in the first place. By then, researchers had realised that capturing animals for scientific or conservation purposes – such as for captive breeding, for mark-and-release studies, or for relocation – was often, ironically, fatal.
1974年，这种现象已经在兽医中广为人知，以至于《自然》杂志在一篇介绍如何避免这一问题的文章中，甚至都不屑于解释“捕捉性肌病”究竟是什么。到那时，研究人员已经意识到一个问题：虽然人工饲养或追踪研究等活动都是出于科学研究和动物保护的目的而捕捉动物，但具有讽刺意味的是，这种行为往往是致命的。
Indeed, by the time that physicians were puzzling over that strange, apparently emotion-driven heart-attack in Massachusetts, veterinarians had already recognised stress-related cardiomyopathy in a tremendous variety of non-human species: elk, pronghorn sheep, moose, deer, scimitar-horned oryx, antelope, muntjac, wisent, gazelle, dugongs, and wild turkeys. Since then, that list has expanded to include duikers, Arabian oryx, dolphins, whales, ducks, little bustards, partridges, river otters, cranes, bats, a variety of shorebirds, and a slow loris. Animals who are most prone to capture myopathy are small mammals, ungulates, birds, and anxious primates.
马萨诸塞州的那个古怪的心脏病突发病例显然是由情绪导致的。然而，当医生们为此困惑不解时，兽医们却早已承认：许多非人类物种都会因为紧张而患上心肌病，包括驼鹿、羊叉角羚、麋鹿、梅花鹿、弯角剑羚、羚羊、麂鹿、野牛、瞪羚、儒艮和野生火鸡。自那以后，这个名单还在不断扩大，小羚羊、阿拉伯大羚羊、海豚、鲸鱼、鸭、小鸨、鹧鸪、河獭、仙鹤、蝙蝠、各种水鸟和懒猴都被包含在内。最容易患捕捉性肌病的是小型哺乳动物、有蹄动物、鸟类和焦虑的灵长动物。
From around the mid-1990s, more case studies in humans, too, began to hint at physiological problems due to extreme psychological stress. In 1995, researchers Jeremy Kark, Silvie Goldman, and Leon Epstein found that Israelis were more likely to die as a result of heart-related problems on 18 January 1991 than on any day in the preceding and subsequent two months, as well as for the same period of time the previous year. That's because that's when the Persian Gulf War began, resulting in 18 missiles directed at Israel from Iraq. To be clear, the increase in mortality measured by this study was not due to injuries directly caused by the missile attacks; they were cardiovascular-related deaths that mostly occurred outside of hospital care.
大约从20世纪90年代中期开始，越来越多的研究显示，人类也有可能因为极端心理压力而出现生理问题。1995年，研究人员杰里米·卡克(Jeremy Kark)、西尔维·高德曼(Silvie Goldman)和利昂·爱普斯坦(Leon Epstein)发现，与之前或之后的两个月以及一年前的同一时期相比，1991年1月18日当天，因为心脏相关的问题而死亡的以色列人数量最多。原因是那一天刚好是海湾战争爆发的日期，伊拉克当天向以色列发射了18枚导弹。需要明确的是，这项研究所显示的死亡率增加并不是因为导弹袭击直接导致的伤病；这些心血管相关的死亡病例多数都没有接受住院治疗。
"The perception of an imminent, life-threatening situation was widespread," the researchers wrote in the Journal of the American Medical Association. "To prepare for chemical attack, gas masks and automatic syringes containing atropine were distributed to the entire population. Every household prepared a sealed room. Civil defence instructions were issued in the media." The entire country was heavy with anxiety to begin with, and the life-or-death fear associated with missile strikes was too much for some to bear.
“很多人都担心很快会发生致命袭击。”研究人员在《美国医学会期刊》(Journal of the American Medical Association)上写道，“为了应对化学攻击，毒气面罩和阿托品自动注射器被派发给所有民众。每一个家庭都准备了一间密封室。媒体也展开了民防教育。”整个国家从一开始就弥漫着极度焦虑的氛围，与导弹袭击有关的死亡恐惧达到了极点，令人难以承受。
The following year, a different group of researchers took a look at sudden cardiac-related deaths in Los Angeles on 17 January 1994. That day was when a magnitude 6.8 earthquake – "one of the strongest earthquakes ever recorded in a major city in North America," the researchers noted – struck the region at 4:31am. In the New England Journal of Medicine, they reported a massive spike in cardiovascular-related deaths due to the stress of the early-morning jolt. As in the case of the Israeli missile attacks, that doesn't include traumatic injuries directly caused by the earthquake. These deaths are instead attributable to the extreme stress of being shaken awake by a violent earthquake. It should be noted, however, that many of those who died were not entirely healthy to begin with.
第二年，另外一组研究人员调查了1994年1月17日在洛杉矶发生的与心血管病有关的死亡病例。那一天早晨4:31，洛杉矶发生了6.8级地震——研究人员指出，“这是北美有记录的最强地震之一。” 他们在《新英格兰医学期刊》上写道，早晨的地震令许多人惊恐万分，导致当天与心血管病相关的死亡病例大幅上升。与以色列导弹袭击相同，这其中并不包含因为地震直接受伤的病例。相反，这些死亡病例都源自在睡梦中被地震惊醒而产生的极度紧张。但需要注意的是，其中很多死亡病例本来也并非完全健康。
In the 1990s Japanese researchers coined the term “takotsubo cardiomyopathy” to describe a stress-induced apparent heart attack. It was so-named because the ballooning of the left ventricle characteristic of this sort of cardiomyopathy is reminiscent to a type of fishing pot, called takotsubo, which are used to trap octopuses.
20世纪90年代，日本研究人员发明了“章鱼壶心机症”(takotsubo cardiomyopathy)这个词，用于描述由紧张引发的明显心脏病。之所以采用这样的名称，是因为这种心机症发病时会导致左心室膨胀，让人想起钓鱼时使用的章鱼壶。
But it wasn't until 2005 that enough studies had been described in the medical literature that human medicine began to fully take note. That year the concept of stress cardiomyopathy was firmly established within the medical literature, though many physicians still refer to is as takotsubo, or occasionally as "broken heart syndrome."
但直到2005年，医学文献中才出现了足够多的相关研究来阐述这种人类医学问题，从而逐渐引发人们的充分关注。那一年，应激性心肌病的地位在医学文献中得以确认，但仍有很多医生称之为“章鱼壶心机症”，或者偶尔称之为“伤心综合征”。
So while it isn’t necessarily sadness or rejection that can hurt us physiologically, there is now little doubt that the mind and our emotions can have a direct, measurable effect on our physical bodies, and when things take a turn for the worse, it can lead to catastrophe.
因此，尽管悲伤未必会给我们造成生理上的伤害，但现在几乎可以肯定的是，心理和情绪能对人体构成显著的生理影响。而当情况恶化时，甚至会引发灾难。
After consulting with veterinarians at the Los Angeles Zoo, it was Natterson-Horowitz, a UCLA cardiology professor, who put the heart-related aspects of capture myopathy with takotsubo cardiomyopathy side by side. In Zoobiquity, she and Bowers, a journalist, ask whether the two syndromes are really one and the same, afflicting humans and animals alike.
在咨询了洛杉矶动物园的兽医之后，加州大学洛杉矶分校的心脏病学教授内特森-霍洛维茨将捕捉性肌病与章鱼壶心肌病中跟心脏相关的部分进行了对比。在《Zoobiquity》中，她和记者鲍尔斯(Bowers)提出这样一个问题：这两种综合征会不会是同一种疾病在人类和动物身上的不同体现？
It’s just a shame that it took so long for doctors to accept what wildlife biologists and veterinarians had known for decades. If this episode teaches us anything, it’s that the traits we share with animals run far deeper than first appears. As this column has explored, the commonalities are myriad, whether it’s the ability to dance, to rule by democracy, or to lure the opposite sex with perfume. They’re written into the very fabric of our biology. Our species occupies but one tiny branch on the enormous tree of life; it would be a shame if our hubris prevented us from applying knowledge derived from decades of research on every other species on the planet to our own.
医生们竟然花了这么长时间才接受一个野生生物学家和兽医们早在几十年前就已经知道的事实，这着实令人惭愧。如果说我们能够从中吸取什么教训的话，那就是人类与动物之间的相同特征远多于最初的想象。正如本专栏之前的文章所述，人类与动物之间存在很多共性，无论是跳舞能力，还是法治民主，抑或通过气味吸引异性。这些共性已经融入了我们的生物学构造之中。我们人类虽然自成一体，但也只是庞大生命树上的一个细小分支而已。如果我们总是固执傲慢，不愿将针对其他物种展开了数十年研究后获得的知识应用到自己身上，那就实在是太遗憾了。
来源：好英语网
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