While anyone can face a broken heart, broken heart syndrome (also known as takotsubo cardiomyopathy or stress cardiomyopathy) is a condition almost unique to women between the age of 50-80. The cause of the heart condition is not completely known, but is thought to be triggered by adrenaline which surges in stressful situations.
When someone’s heart experiences broken heart syndrome, their heart (when observed in the catheterization laboratory) resembles the pots that fisherman use to capture octopi in Japan (aka a takotsubo).
First described as “takotsubo syndrome” in Japan in 1991, it is now recognized as the cause in approximately 2 percent of all “heart attack” syndromes.
While the condition is uncommon, women who do experience Broken Heart syndrome present symptoms just like an acute heart attack — experiencing acute chest pain, shortness of breath, and EKGs which look very much like an acute Myocardial Infarction (MI). The difference between this and a true heart attack is that the heart arteries in broken heart syndrome typically have no significant blockage. The other major difference is that in broken heart syndrome the damage that occurs to the heart heals fairly rapidly (sometimes in as little as a few weeks).
Diagnosis is made based on a patient’s symptoms, an EKG, heart enzyme analysis — troponin, and either a cardiac catheterization or an echocardiogram showing the dilated and dyrfunctional heart muscle.
Treatment is with medications. Typically, the same medications (e.g. beta blockers or angiotensin converting enzyme inhibititors) which are used in heart attacks are used for these patients, if for a shorter period of time. Patients can become very sick during the period of time they have this condition, and sometimes have to be supported through episodes of acute congestive heart failure and shock. Occasionally medication or even life support is necessary to get them through the worst parts.
What causes Broken Heart Syndrome, and can we predict it?
While the thought is that it is always a stressful emotional situation which causes this condition, it can also be seen in situations of physical stress. Infections or having surgery can precipitate it. We have seen cases caused by funerals, death of a loved one, or even while being arrested.
Although broken heart syndrome is typically caused by negative stress, about half of the cases are not caused by a particular stressor. It just happens. Since this condition closely mimics a true heart attack, if you have the sorts of symptoms which occur during either situation (chest pain, shortness of breath, nausea and vomiting), the most important thing to do is seek quick medical attention.
Although broken heart syndrome can be fatal, death from this condition is, thankfully, quite rare. The vast majority of patients who have this condition recover completely, and what’s interesting is that almost no one who has had this ever has it happen to them again.
We currently have a registry of over 150 individuals who have had this happen to them, and continue to examine these patients, improve the treatment, and explore the potential causes of this interesting (and sometimes dangerous) condition.
About the author
Dr. Schussler is a general and interventional cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas and Baylor University Medical Center. His interests include preventative cardiology, coronary stents, trans-radial (through the wrist) coronary intervention. More recently, his research has focused on non-invasive coronary imaging using CT scans, as well as robotic-assisted angioplasty. He is active on Twitter @Updock typically posting on new technologies and techniques in cardiology.