Did your mother ever accuse you of giving her a heart attack? Maybe she exclaimed this when, with eyes closed, she put out her hand expecting a lovely bunch of hand-picked wildflowers. Instead, you handed her a toad.
Or maybe you heard the sad story of a widow who soon died after losing her beloved husband. The whispers said she died of a broken heart.
Broken Heart Syndrome, also known as Takotsubo Cardiomyopathy (TC), is a heart condition that may result from experiencing a stressful event or extreme emotions. Named after the Japanese word for octopus trap (takotsubo), which resembles the shape of the left ventricle in an affected heart, this condition was first described in 1990 in Japan.
Women over the age of 50 account for 90% of the cases of TC. Theories suggest that postmenopausal women are more susceptible after losing the protection estrogen provides against assaults on the heart.
Signs and Symptoms
While TC is not technically a "heart attack," the symptoms are similar - chest pain, shortness of breath, and dizziness – and may come on suddenly after a stressful event. Unlike a heart attack or myocardial infarction, the symptoms are not caused by a blocked cardiac artery.
What causes Broken Heart Syndrome?
The exact cause of TC is unclear. Current thinking suggests that the syndrome may be caused by the surge of catecholamines experienced during a stressful event. Catecholamines – adrenaline, noradrenaline, and dopamine - drive your Fight-or-Flight response. When released, these chemicals increase your heart rate and blood pressure. A massive amount of these chemicals may overwhelm the heart, causing the left ventricle to become misshaped, temporarily disrupting the heart's pumping function.
The left ventricle is the heart's primary pump supplying blood to the body. When it is not functioning correctly, heart failure occurs.
Diagnosis and Treatment
Because TC shares symptoms with a heart attack, clinicians will perform blood work to look for cardiac markers and an EKG. Most patients will undergo an angiogram to find any blockage in the arteries supplying blood to the heart. An echocardiogram may be performed to examine the structure and valves of the heart to see how well the heart is pumping blood.
TC is a diagnosis of exclusion, which means there are no specific tests to detect its presence. The diagnosis is made by excluding other factors, such as coronary artery disease.
There are no exact guidelines for treating TC. Management is generally conservative and individualized based on symptoms. Doctors may prescribe medications to help the heart pump blood more efficiently or remove excess fluid from the blood.
Treatment may focus on stress-reduction activities, decreased caffeine use, and smoking cessation to prevent recurrence.
Prognosis and Long-term Outlook
TC may lead to complications such as low blood pressure, blood clots, irregular heartbeat, or cardiogenic shock, a condition where the heart doesn't pump enough blood to meet the body's needs.
Most patients' symptoms of TC usually resolve in weeks, and 90% fully recover within two months. The reported prevalence of relapse ranges from 1.8 to 10%.
TC underscores the powerful impact our emotional state has on our physical health. During American Heart Month, be good to your heart by managing your stress and emotions.
https://www.svhhearthealth.com.au/conditions/takotsubo-cardiomyopathy#:~:text=Takotsubo%20cardiomyopathy%20is%20a%20temporary,ability%20to%20pump%20blood%20effectively. https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome Assessed and Endorsed by the MedReport Medical Review Board