Last Updated on April 13, 2023 by Mike Robinson
The broken heart syndrome or Takotsubo cardiomyopathy is a disease that affects the heart muscle (temporarily), but unlike heart attack or heart attack, in this condition there is no obstruction of the coronary arteries.
In the broken heart syndrome, the left ventricle of the heart (which is responsible for pumping oxygenated blood throughout the body) is noticeably weakened from one moment to another, apparently due to a situation of great stress experienced by the patient.
Although it is not a well-known condition, this syndrome is more frequent than you think. Since the symptoms can be confused with those of a common heart attack, sometimes it is not correctly diagnosed.
Characteristics of broken heart syndrome
In this syndrome the heart can not pump blood efficiently and the person feels pain in the chest and breathing difficulties, as if he was suffering a heart attack, although in reality he is not.
Despite the weakening of the left ventricle of the heart, most patients recover fully after a few weeks.
The broken heart syndrome is also known as “Takotsubo cardiomyopathy”, as the first case was described in Japan and the name Tako-Tsubo corresponds to a conical shaped vessel used to capture octopi.
In cases of broken heart syndrome, the left ventricle of the heart acquires a shape similar to that of this vessel.
Other names with which this disease is known are transient apical dysfunction or stress myocardiopathy.
Main symptoms of broken heart syndrome
In the beginning, the symptoms may be identical to those of a heart attack. The person suddenly feels an intense pain in the chest and a feeling of shortness of breath.
There may also be arrhythmias and heart failure.
These symptoms usually occur suddenly after the patient experiences a situation of great physical or emotional stress.
How is broken heart syndrome different from heart attack?
What happens in the infarction is the following :
The coronary arteries, which carry blood with oxygen and nutrients to the cells of the heart, gradually reduce their caliber due to deposits of cholesterol and nicotine until a clot completely obstructs its light.
When this happens the cells of the cardiac muscle can not receive oxygen and die, causing the infarction, that is to say, the death of part of the cardiac tissue .
In contrast, in broken heart syndrome, what apparently happens is this:
(I say apparently because in reality the mechanisms are not yet well known).
When the patient lives in a situation of great stress, such as the death of a loved one, the loss of his job, a breakup of a couple or major surgery, the bloodstream is invaded by a large amount of chatelaines ( adrenaline and noradrenaline), chemical substances associated with stress.
For reasons that are still unknown, in certain people these catecholamines weaken the walls of the left ventricle of the heart, causing the broken heart syndrome.
As you see, in this case there are no clogged arteries or death of the muscle cells of the heart.
Factors that can trigger Takotsubo’s cardiomyopathy
As you have already read in previous paragraphs, the researchers believe that the main cause of the weakening of the heart are the high levels of adrenaline and noradrenaline in blood, caused in turn by a situation of great stress.
These are the main triggers that have been found:
Surprise death of a loved one very close (child, parents, spouse).
Terrifying medical diagnosis (cancer for example).
Situations of domestic violence.
Lose large sums of money.
Losing the job
Surprise parties.
Divorce.
Have to speak in public.
Natural disasters (floods, hurricanes, earthquakes, etc.).
Physical stress due to a great trauma (traffic accident for example), major surgery or asthma attack.
Although not as frequent, some medications can also be the cause of broken heart syndrome.
How is broken heart syndrome diagnosed?
If a family member, a friend or yourself suddenly felt a strong pain in the chest and shortness of breath, they will surely think that it could be a heart attack and you would immediately call an ambulance.
But once arrived at the hospital, the following tests are those that help to rule out the possibility of infarction and to orient the diagnosis towards the broken heart syndrome:
Electrocardiogram
The alterations in the electrical waves of the heart are different from those that appear in the infarction.Blood tests They do
not reveal lesions in the heart muscle.Echocardiogram
Shows a bulging and unusual movement of the left ventricle of the heart.Angiography
shows no obstructions in the coronary arteries.
If in addition the patient has recently suffered some intense stress situation , then it is likely to be a broken heart syndrome (it is justly called that because in many cases, the trigger is the death of someone very dear).
But before reaching this conclusion, the doctor should always rule out other possible causes for chest pain, such as trauma or trauma.
Questions that the doctor will surely ask
If you are having chest pain, surely the doctor will ask you the following questions:
What symptoms do you have?
When did they start?
Does the pain in your chest radiate to other parts of the body?
Does pain increase momentarily when the heart beats?
How would you describe the pain?
Do symptoms get worse with exercise or exertion?
Do you have a family history of heart problems?
Do you suffer from a chronic illness?
If the doctor finally diagnoses you with stress myocardiopathy, then surely you will have many questions as well.
Questions you want to ask if you have this syndrome
If you have had symptoms of a heart attack but after performing some tests it has been confirmed that it is not really a heart attack but it is broken heart syndrome, it is important that you finish with all doubts and ask the doctor the following :
What has caused my symptoms?
What tests will you perform?
Is it necessary for me to stay in the hospital?
What will be the treatment to follow?
How long will my heart recover?
Can I lead a normal life?
Can these symptoms appear again?
Most patients with broken heart syndrome stay in the hospital for a few days. When they return to their homes, they continue to take some medications for one or two months, and after the total recovery of their heart, they are likely to be able to stop the medication.
In general, this syndrome does not leave any kind of long-term consequences. But it is also true that there are fatal cases, in which the patient dies shortly after presenting the symptoms (although these are rare cases).
Treatment to follow
You may be surprised to learn that there are no guidelines for the standard treatment in broken heart syndrome.
In general, the doctor acts as if it were a heart attack, until it is discovered that it is a cardiomyopathy due to stress.
Most people remain hospitalized for a few days, until heart function improves.
Once the diagnosis is clear, the doctor will probably order cardiac medications, such as angiotensin- converting enzyme inhibitors, beta-blockers, or diuretics.
These medications help to reduce the workload that the heart must perform, and in this way the recovery of the heart muscle is favored.
If you have had this syndrome, the doctor will probably tell you to continue with this medication for a month or two, until the heart has completely recovered.
When the anatomy and functionality of the heart have returned to normal, you may be able to stop medications (not without consulting the doctor, of course).
In general, broken heart syndrome occurs only once, although there is a remote possibility of recurrence.
How to prevent broken heart syndrome
Although there is no treatment that has been shown to be effective in preventing this syndrome, if you take the following measures you will surely reduce the chances of it happening:
Try to avoid situations that generate stress.
If you can not avoid it and you are already experiencing some type of emotional or physical stress situation, then the techniques to deal with stress can be useful: meditation, yoga, breathing techniques and relaxation are some good examples.
Share your feelings with friends and family who support you. This is also useful to relieve the stress you are suffering.
Moderate physical exercise is another tool that you can use to decrease the effects of stress on your body.
Be careful, some people try to deal with stress in unhealthy ways: drinking alcohol, smoking or eating too much. Avoid these behaviors please, if you want to have a healthy heart.
Curiosities
Did you know that 1% to 2% of people diagnosed with a heart attack have actually suffered from broken heart syndrome?
Experts continue to study this condition to better understand its causes and thus develop more effective treatments and perhaps methods that can prevent it.
Among other things, it has been discovered that broken heart syndrome affects many more women than men: approximately 90% of the cases studied correspond to women who are in the post-menopausal stage.
It is also not known why, but broken heart syndrome is more frequent in the spring and summer months, unlike infarction, which occurs more frequently in winter.
Do you know how the name “broken heart syndrome” came about? Well, Dr. Ilan Wittstein of the University of Johns Hopkins, who has studied this condition for a decade, says that this name came after checking that many of the patients who had it had lost a family member recently.
In most cases it was the spouse, the father or the mother. Some of them even began to feel the first symptoms during the funeral, says the doctor.
Other patients had just suffered a car accident or an assault . Wittstein says he even once treated a 60-year-old patient with a broken heart syndrome who began to feel the pain shortly after family and friends shouted “Surprise” at the party for his birthday, that she did not know anything of course.
If all the cases studied by Hopkins University are taken into account, the average age of patients with broken heart syndrome is 63 years, although there was one case of a woman with 27 years of age and another of 32 years of age.
Some of these women had hearts so badly damaged that they might have died if they had not received aggressive treatment to keep their blood circulating. However, all of them recovered completely.
In general terms, it can be said that this syndrome has a fairly low mortality rate, around 5%.
The researchers point out that it is very important to differentiate broken heart syndrome from a heart attack , so that people can be treated correctly and to be informed that their hearts will fully recover.
In this way patients will not leave thinking that their heart has suffered permanent damage and will need to take heart medications for the rest of their lives.
Also Read: Koro Syndrome: Symptoms, Causes, Treatments
The discovery of this syndrome, which often occurs after the death of a close relative, suggests that the old idea that it is possible to die of grief or fear , as it is said in some songs and novels, may contain some truth.
