Dear Doctor: I heard that eating some wasabi gave a woman a heart attack. I love sushi and have it a few times a week, and I do use wasabi. Do I have to stop?

Dear Reader: Recent news reports described how a woman who ate wasabi, also known as Japanese horseradish, was hospitalized with heart problems. However, the details of the incident are important to know.

The incident you’re referring to involves a 60-year-old woman who was a guest at a wedding reception in Israel. She took a scoop of what she thought was guacamole, but instead of a smooth and creamy bite of avocado, she actually ate a large spoonful of wasabi. Moments later, her chest felt heavy, and a sensation of pressure radiated out to her arms. This lasted a few hours, then went away. The next day, feeling weak and uncomfortable, she went to the hospital. Initial tests came back with results consistent with a heart attack, but further testing failed to find any blockages or muscle damage. Instead, imaging tests showed that the woman’s heart had become misshapen, something that happens in a condition called stress-induced cardiomyopathy.

Often referred to as broken heart syndrome, the condition occurs when the left ventricle, one of the four chambers of the heart, becomes enlarged and weakened and is unable to pump blood effectively. The colorful name comes from the fact that the stressors that trigger the syndrome can be both physical and emotional, such as the loss of a loved one.

The initial confusion as to this specific woman’s condition isn’t surprising, since the symptoms of broken heart syndrome are similar to those of a heart attack. This includes the chest pain, weakness and shortness of breath that the wedding guest had experienced. Even the results of some clinical tests, including electrocardiogram abnormalities, can mirror those seen in a heart attack. Although the exact causes of broken heart syndrome aren’t known, it’s suspected that the sudden and unusual surge of stress hormones is somehow toxic to the heart muscles of some people.

Risk factors for the condition are gender and age. Up to 90% of cases are in women ages 58 to 75. People with a neurological disorder, such as epilepsy, and some psychiatric disorders may be at increased risk. Treatment is with heart medications, including ACE inhibitors to lower blood pressure; beta blockers to slow the heart rate; and anti-anxiety medicines. In most cases, the effects of broken heart syndrome are often temporary and reversible.

Wasabi is a small green plant prized for the pungent and peppery flavor of its rootstalk. It gives its name to the spicy, creamy condiment that typically accompanies sushi and other foods. It’s quite costly, though, so the bright green paste we think of as wasabi is often mostly horseradish, with a just a dash of actual wasabi mixed in. As for your concern about eating wasabi, it wasn’t the condiment itself that triggered the woman’s condition, but rather the unusual quantity that she ingested. Used in tiny amounts, as intended, wasabi shouldn’t present any danger.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I’ve been eating a vegan diet for about a year. My mom says she read that vegans don’t get enough choline, and that’s dangerous. Is this true? What is choline, and where does it come from?

Dear Reader: Choline is an essential nutrient that is abundantly available in animal-based products such as eggs, dairy products, beef, chicken and fish, and in somewhat smaller concentrations in vegetables, legumes and grains. It’s the source of chemical compounds known as methyl groups, which circulate in the body and play a role in the proper functioning of numerous metabolic processes in the brain and nervous system, including mood, memory and muscle control.

Choline is vital to the proper structure and performance of cell membranes, including those in the brain, and it is important in gene expression. It has been linked to lower levels of chronic inflammation, and offers protective properties in certain types of heart disease. It’s also important in early development.

Although choline is produced by the liver, the quantities are not adequate for the body’s daily needs. That’s what makes it an “essential nutrient.” There is no recommended daily allowance for choline. Instead, a guideline known as Adequate Intake, or AI, has been established. For adults, the AI is 425 milligrams per day for women and 550 milligrams per day for men. For children, the number ranges from 125 milligrams per day for infants to 375 milligrams per day for young teens. Because choline is so important to development, women who are pregnant or nursing need more of the nutrient.

According to the National Institutes of Health, most people in the United States, whether vegans, vegetarians or omnivores, fall short on consumption of the nutrient. And while it’s true that animal-based foods have the highest levels of choline, plant-based sources are also widely available. Certain vegetables, beans and grains are good sources of choline. For example, one-half cup of roasted soybeans has almost as much choline as 3 ounces of lean beef. One-half cup of broccoli has only slightly less choline than 1 cup of low-fat milk. A cup of cauliflower has as much choline as 3 ounces of grilled chicken.

If your personal preferences steer you away from choline-rich foods, you can consider making up the shortfall with supplements. Just be sure to stick to the dietary guidelines and not to go overboard. Too much choline can result in nausea and vomiting, excess sweating and salivation, low blood pressure and liver problems.

The bottom line here, as always when we’re talking about health and nutrition, is to avoid the empty calories in the snack food aisle and the fast food drive-through, and focus instead on eating and cooking from a wide range of whole foods. Your body -- and, we suspect, your mother -- will thank you.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: One of the moms in our car pool had to drop out because she has a frozen shoulder. I’ve never heard of that. What is it, and how did she get it?

Dear Reader: Frozen shoulder, also known as adhesive capsulitis, is a common and painful condition in which the connective tissues around the shoulder joint gradually become thickened and inflamed. It’s more common in women than men, and it more commonly occurs in people from ages 40 to 60. With a frozen shoulder, previously simple activities like raising your arms to slip into a T-shirt or even reaching up to scratch your head become very difficult.

To understand the condition, let’s start with the shoulder joint itself. It’s a ball-and-socket joint, which means that the rounded head of the humerus, which is the upper arm bone, fits into a cuplike structure located on the scapula, or shoulder blade. Cartilage, which is smooth and elastic, covers the surfaces of the bones where they meet. It acts as a shock absorber, and its sleek surface helps to reduce friction and smooth movement. Meanwhile, strong ligaments that attach to the “ball” of the humerus and to the shallow “socket” on the scapula hold the parts of the shoulder joint in place. Taken together, this allows for a wide range of motion. In fact, the ball-and-socket joint offers the most freedom of movement of any type of joint in the body.

When inflammation causes the connective tissues within the shoulder joint to become thick and stiff, the capsule tightens. In some cases, scar tissue forms, which further limits range of motion. All of this makes any kind of movement within the joint, whether active or passive, both difficult and painful.

Frozen shoulder can develop when injury, trauma or surgery have forced long-term immobility. It is also seen more often in people at risk of developing diabetes, and those with chronic inflammatory arthritis. The condition begins with localized discomfort or pain, which gradually increases over time. It can take from two to 10 months for a frozen shoulder to develop. During the “frozen” stage of the condition, which can also last for months, the joint becomes difficult, if not impossible, to move. The good news is that during this time, pain from the condition may decrease. Eventually, range of motion begins to return to the joint.

In order to eliminate other potential causes, imaging tests like an MRI or an X-ray may also be used. Treatment focuses on alleviating pain and recovering range of motion. This entails the use of various anti-inflammatory medications, and possibly injections of corticosteroids into the joint capsule. Patients are also taught exercises to stretch the joint capsule, and when recovery begins, strengthening exercises. Infrequently, surgery may be required. Most cases of frozen shoulder resolve within a year or two.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)