Broken Heart Syndrome (Takotsubo Cardiomyopathy)
Going through an extremely difficult and emotional time, such as coping with the death of a loved one, can be heart breaking. Although people may feel as if their heart is in pain, is there actually something wrong with their heart? The answer may be surprising.
In some cases of emotional difficulty, there can be symptoms caused by an actual medical condition. Broken heart syndrome occurs when the left ventricle of the heart temporarily enlarges and does not pump blood efficiently. According to Harvard Health Publications, the condition was originally described in 1990 and known as takotsubo cardiomyopathy. The name originated because the ventricle enlarges and takes on the shape of a takotsubo, which is a Japanese fishing pot for catching octopus.
Broken heart syndrome appears to develop after an extremely emotional event, such as sudden grief from the death of a loved one. Other intense emotions can also precipitate the condition including extreme surprise, fear and intense anger. Various physical stressors, such as asthma attacks, seizures or a stroke can also lead to the condition.
During an extremely intense emotional experience, the body produces hormones like adrenaline and noradrenaline. It is not clearly understood how the stress hormones affect the heart. Hormones, such as adrenaline, may cause a narrowing of the arteries, which may cause a temporary decrease in blood flow to the heart. In some instances, the hormones may also cause the left ventricle of the heart to temporarily enlarge or balloon. This enlargement leads to symptoms of heart failure.
It is important to understand that while chronic stress can affect the body in various ways, it does not appear to be one of the causes of broken heart syndrome. However, sudden and unexpected stress can be a primary cause.
Symptoms usually develop shortly after a person experiences an intense emotional stressor. Symptoms of broken heart syndrome are often very similar to that of a heart attack. In fact, symptoms are so similar, broken heart syndrome is often initially diagnosed as a heart attack. Symptoms may include:
- Breathing difficulty including shortness of breath
- Chest pain
- Fatigue or weakness
- Abnormal heartbeats
- Low blood pressure
Symptoms, such as those listed above should never be ignored. It is important to understand the condition does cause the heart muscle to become temporarily weaker. Due to the weakened state of the heart various complications are possible, such as life threatening heart rhythms, shock and low blood pressure. Careful monitoring of patients with the condition is needed to identify serious complications quickly.
Most of the diagnostic procedures ordered are similar to those performed to rule out a heart attack or other cardiac conditions. A physical exam will be done along with an electrocardiogram to determine if there is an abnormal heart rhythm. A chest x-ray and echocardiogram are also often ordered to check for changes in the heart structure. The echocardiogram will allow a physician to view the left ventricle to determine if it has enlarged.
Blood tests are also performed to measure various cardiac markers. Cardiac markers, such as troponin, usually rise in people with conditions, such as a heart attack. In individuals with broken heart syndrome there may also be a small increase in certain cardiac enzymes.
Treatment for broken heart syndrome may depend on the severity of symptoms. With an enlarged left ventricle, fluid retention on the lungs may develop. If this occurs, diuretics may be given to decrease fluid buildup in the lungs and improve shortness of breath. Medications, such as beta blockers and ACE inhibitors, which help the heart pump more efficiently may be given until the condition reverses itself. Blood pressure medication may also need to be administered.
Treatments used for other cardiac conditions, such as coronary artery disease or a heart attack are not used. Since the cause of symptoms is not blocked arteries, treatments like angioplasty are not helpful.
More Common In Women
Although broken heart syndrome can occur in either gender, it is much more frequently diagnosed in women. Women are more than seven times as likely to develop the syndrome, especially women over the age of 55. Although doctors are not sure exactly why it develops more commonly in women, there may be a hormonal connection. According to John Hopkins Medicine, additional research is needed to determine why middle age and elderly women are most prone to broken heart syndrome.
The connection between emotions and physical symptoms is evident in people with broken heart syndrome. Additional research is being done to determine why some people actually develop physical changes within their heart. According to John Hopkins Medicine, having one incidence of broken heart syndrome does not mean it will happen again if a sudden stressor occurs. Although it may be impossible to prevent an intense reaction to extreme stressors, the good news is the condition often reverses itself quickly without causing permanent damage.