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Serotonin-Induced Heart Disease - Effects, Risk Factors, Diagnosis and Symptoms

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If used for the long term, serotonin, a neurotransmitter, can induce heart valve disorder. This article is brief on serotonin-induced heart diseases.

Medically reviewed by

Dr. Chopda Anand Manaklal

Published At April 30, 2022
Reviewed AtMarch 8, 2023

Introduction

Serotonin is a chemical messenger produced by the cells of specific nerves. The function of serotonin is to pass electrical signals between the nerve cells. Serotonin is found abundantly in the digestive system. It is also found in the blood platelets and the entirety of the CNS or central nervous system. Serotonin is mainly composed of an essential amino acid called tryptophan. This amino acid is present in the body through a diet rich in nuts, legumes, cheese, and red meat.

A deficiency in tryptophan will eventually lead to serotonin deficiency. This results in mood alterations such as depression, panic, and anxiety. Not only this, but serotonin also has an effect on the cardiovascular system, especially the heart. Serotonin is known to escalate the heart rate, increase the contraction forces of the heart chambers, alter the heart rhythm, and cause obstruction in the coronary artery. It has been thoroughly studied that serotonin causes certain cardiac events that hamper the heart's normal function. These events are generally present in teenagers and younger individuals. In addition, serotonin is secreted by the blood platelets. This can have an effect on the cardiac muscles as well as heart walls and valves. Therefore serotonin is one of the factors that may induce heart diseases in the long run.

What Are the Effects of Serotonin on the Heart and the Cardiovascular System?

Serotonin is a naturally occurring chemical substance that is vasoactive in nature. It is found in the blood platelets but also in the brain. It is produced in the gastrointestinal system and then smoothly released into the bloodstream. The blood platelets rapidly blend with the serotonin and also store them. Serotonin has an array of influences on the cardiovascular system. The blood vessels are dilated due to the chemical composition of serotonin. Additionally, the blood vessels respond to serotonin in a contractile manner that may lead to some cardiac diseases such as coronary artery disease or heart valve disorders.

The various effects of serotonin on the heart are mentioned below.

  • Constriction of the heart vessels.

  • Dilation of other coronary arteries.

  • Trigger factor for vasoactive mediators in the heart.

  • Increased mobility of the gastrointestinal lining.

  • Regulation of the sleep pattern.

  • Increased thickness of blood.

  • Decreased deformability of the red blood cells.

  • Increased volume of cardiac stroke.

  • Increases pulmonary artery pressure.

  • Systemic hypertension.

  • Atherosclerosis.

  • Coronary artery disease.

  • Aortic valvular disease.

  • Fibrosis secondary to vascular diseases.

  • Increased cardiac output.

  • Increased chronotropy and ionotropy.

  • Increased platelet aggregation.

  • Decreased release of norepinephrine.

  • Chronic valvular disease.

  • Vasoconstriction of the arterial beds.

  • Expansion of angiotensin and histamine receptors.

  • Constriction of large arteries.

  • Inflammation of the heart valves.

  • Vasodilation of large veins.

  • Calcification of the heart valves.

  • Mitral valvular myxomatous degeneration.

  • Heart failure if not treated and diagnosed.

Who Are at a Risk of Developing Serotonin-Induced Heart Disease?

A particular group of individuals has a medical history that pushes them to the brink of developing a heart disorder due to serotonin. However, this is not the case for each and every individual. Mentioned below are some of the conditions of patients, if present, can prove to be a predisposing factor for developing serotonin-induced heart disease.

  • Congenital bicuspid aortic valves.

  • Rheumatic fever.

  • An episode of myocardial infarction.

  • Long-term use of antidepressants.

  • Long-term use of anti-anxiety medications.

  • Degenerative aortic valve stenosis.

  • Progressive valvular disease.

  • Myocarditis.

  • Septum defect of the heart.

  • Aortic regurgitation.

  • Neuroendocrine tumor.

  • Aortic stenosis.

How to Diagnose Serotonin-Induced Heart Diseases?

There are several diagnostic tools and multiple tests to check if there is the presence of any heart damage or heart condition due to serotonin. Mentioned below are some of the diagnostic measures for the same.

  • Transthoracic echocardiography.

  • Chest X-ray.

  • Electrocardiography.

  • 24-hour urine examination.

  • Physical examination.

  • Complete medical history documentation.

  • Drug history study and analysis.

  • Complete blood picture.

  • Stress tests such as treadmill tests.

  • Cardiac catheterization.

  • Holter monitoring.

  • Cardiac computerized tomography scan.

  • Cardiac magnetic resonance imaging.

What Are the Symptoms of Serotonin-Induced Heart Disease?

Interaction of serotonin and the cardiovascular system can manifest with an array of signs and symptoms. However, this is not the situation with every individual because there have been studies where patients diagnosed with serotonin-induced heart disease show no signs or symptoms. Mentioned below are some of the clinical manifestations of serotonin-induced heart disease.

  • Restlessness.

  • Dilated pupils.

  • Heavy sweating.

  • Headache.

  • Confusion.

  • Rapid heart rate.

  • High blood pressure.

  • Decreased cardiac output.

  • Tremors.

  • Irregular heartbeat.

  • Syncope.

  • Arrhythmia.

How to Avoid Serotonin-Induced Heart Diseases?

A complete list of medications should be shared with the respective healthcare provider. Any antidepressant medicines should not be administered without the consent and prescription of a professional. One should make sure to discuss all the signs and symptoms they have experienced over the period of time. Any underlying cardiovascular disorder, family history of heart diseases, or cancer should be known to the healthcare provider. Emergency care should be prompt in case of any seriousness of heart symptoms.

How to Treat Serotonin-Induced Heart Disease?

There has been extensive research and study on the usage of serotonin receptor antagonists as a treatment modality for multiple kinds of cardiovascular diseases. The most widely used serotonin antagonist is Ketanserin. Ketanserin blocks the actions of serotonin on the blood vessels, such as vasoconstriction, thus canceling hypertension and other commonly known effects of serotonin. In addition, Ketanserin also has proven to have serotonin antagonist effects within the central nervous system.

Conclusion

Serotonin is a chemical that helps stabilize the mood by substantial effects on the central nervous system. In the long term, serotonin hampers the normal functions of the heart in numerous aspects. It damages crucial elements of the heart that may, in turn, result in various problems throughout the body. The patient should be educated about medications such as antidepressants. Patients should also explain their drug and medical history to their healthcare provider. These are vital for the professional to draft a direct line of treatment.

Frequently Asked Questions

1.

How Does Serotonin-Induced Heart Disease Lead To Fibrosis?

The cells of particular nerves create the chemical messenger serotonin. Serotonin carries electrical information between nerve cells in the body. Tissue fibrosis is stimulated by serotonin. This produces fibrosis secondary to vascular disorders as well as fibrosis of the heart's valves, also known as cardiac valves.

2.

What Are the Common Serotonin-Induced Heart Disease Symptoms?

 - Restlessness.
 - Dilated pupils.
 - Heavy sweating.
 - Headache.
 - Confusion.
 - Rapid heart rate.
 - High blood pressure.
 - Decreased cardiac output.
 - Tremors.
 - Irregular heartbeat.
 - Syncope.
 - Arrhythmia

3.

What Are the Causes of Serotonin-Induced Heart Disease?

When people raise the amount of some medications or begin taking a new prescription, people may have serotonin syndrome. Combining serotonin-containing drugs, such as a migraine medication and an antidepressant, is the most common cause. The neurotransmitter serotonin can have a negative impact on the mitral valve of the heart, contributing to the heart ailment known as degenerative mitral regurgitation.

4.

Who Is at Risk of Developing Serotonin-Induced Heart Disease?

Patients with the following conditions are at increased risk:
 - Congenital bicuspid aortic valves (heart problem present at birth).
 - Rheumatic fever (inflammatory disease).
 - An episode of myocardial infarction (heart attack).
 - Long-term use of antidepressants.
 - Long-term use of anti-anxiety medications.
 - Degenerative aortic valve stenosis (heart valve disease).
 - Progressive valvular disease.
 - Myocarditis (inflammation of the heart muscle).
 - Septum defect of the heart.
 - Aortic regurgitation (reverse blood flow).
 - Neuroendocrine tumor (cancer of neuroendocrine cells). 
 - Aortic stenosis (narrowing of the aortic valve opening).

5.

How to Treat Serotonin-Induced Heart Disease?

Serotonin disorder usually resolves within 24 hours of stopping the serotonergic medication and starting treatment, although medicines with long half-lives or active metabolites may cause symptoms to remain. Benzodiazepines like diazepam (Valium, Diastat) and lorazepam (Ativan) can aid with agitation, seizures, and muscle stiffness. Agents that inhibit serotonin synthesis. If other therapies are ineffective, medicines like cyproheptadine can aid by inhibiting serotonin synthesis.

6.

How to Diagnose Serotonin-Induced Heart Disease?

Serotonin-induced heart disease can be diagnosed by:
 - Transthoracic echocardiography.
 - Chest X-ray.
 - Electrocardiography.
 - 24-hour urine examination.
 - Physical examination.
 - Complete medical history documentation.
 - Drug history study and analysis.
 - Complete blood picture.
 - Stress tests such as treadmill tests.
 - Cardiac catheterization.
 - Holter monitoring.
 - Cardiac computerized tomography scan.
 - Cardiac magnetic resonance imaging.

7.

Is Anxiety Because of Serotonin-Induced Heart Disease?

Serotonin is a molecule that occurs in the body and has a vasoactive effect. Both the brain and blood platelets contain it. It is created in the digestive tract and then gradually released into the circulation. Serotonin and blood platelets combine quickly, and the platelets also store serotonin. Anxiety is one of the many effects of serotonin on the cardiovascular system.

8.

Can Caffeine Lead To Serotonin-Induced Heart Disease?

Serotonin is a chemical that helps stabilize mood by substantially affecting the central nervous system. In the long term, serotonin hampers the normal functions of the heart in numerous aspects. It damages crucial elements of the heart that may, in turn, result in various problems throughout the body, and caffeine does trigger serotonin production.
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Dr. Chopda Anand Manaklal
Dr. Chopda Anand Manaklal

Cardiology

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