You have heard someone say it before, “they died of a broken heart”. Broken heart syndrome is a real condition brought on by stressful situations, such as the death of a loved one. Others at risk for the condition include mostly postmenopausal women, some stroke patients, persons with an acute medical illness and those undergoing surgical procedures.
Takotsubo or stress cardiomyopathy (where the heart temporarily enlarges and the heart muscle weakens) is rare but reversible. It is also known as “apical ballooning syndrome” as the left ventricle resembles the Japanese word for a “fishing pot for trapping octopus” when heart x-rays are taken. The contraction of your left ventricle (one of the four chambers) of the heart causes a balloon-like shape on a heart angiogram. This is Takotsubo stress cardiomyopathy or broken heart syndrome.
SYMPTOMS:
Symptoms includes dyspnea (shortness of breath), chest pain, cardiac arrhythmias (disorders of the heart rate) such as bradycardia (heart rate slow), atrial fibrillation (quivering of heart muscle), ventricular tachycardia (fast heart rate) and acute pulmonary edema (lung congestion). The person, predominately women, usually have had a recent physical or emotional stress in their lives.
Diagnosis can be difficult as the EKG (electrocardiography) findings may show you are having an acute myocardial infarction or heart attack. Patients appear anxious, diaphoretic, tachycardic or bradycardic, hypotensive (low blood pressure), have heart murmurs and lung edema. A stress induced catecholamine release (surge of stress hormones) or adrenalin may explain the mechanism for broken heart syndrome. During a cardiac catheterization there is no evidence of obstructive coronary artery disease. Lab values for cardiac event are mild to moderately elevated.
TREATMENT:
Treatment is supportive and usually effective if patient survives the severe heart failure state. An echocardiogram needs to be performed within days or weeks after the acute onset to see if the ventricular abnormalities are reversed. Prognosis is usually good with physician follow up. Broken heart syndrome or takotsubo cardiomyopathy is rare and requires more research, especially in the occurrence with women. With any long lasting or persistent chest pain, you could be experiencing a heart attack and need to call 911 or seek immediate medical attention.
SOURCES:
Mayo Clinic: http://www.mayoclinic.com/health/broken-heart-syndrome/DS01135
The “Broken Heart Syndrome: Understanding takotsubo cardiomyopathy.” By Dawn Derrick
http://ccn.aacnjournals.org/cgi/reprint/29/1/49.pdf
Texas Heart Institute Journal: “Takotsubo Cardiomyopathy, or Broken Heart Syndrome”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1847940/
eMedicine: Cardiomyopathy, Takotsubo: http://emedicine.medscape.com/article/1513631-overview
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