Takotsubo Cardiomyopathy, also known as Heartbroken Syndrome

Azadeh Beheshtian | May 17, 2024

Can You Die From a Broken Heart?

Every person, at some point in their lives or another, is likely to experience heartbreak at least once. Whether brought on by a bad breakup, the death of a loved one, a grave financial loss, or a serious accident, heartbreak is a part of human life. This emotional stress may lead to a heart condition known as Takotsubo cardiomyopathy or Broken Heart Syndrome, often called Stress-Induced Cardiomyopathy.

Predominantly affecting female patients between 58 and 75, this temporary condition was first classified in Japan in 1990. Although most people with broken hearts recover without heart damage, broken heart syndrome treatment is not yet standardized. High-stress situations or drastic surges in stress hormones trigger this condition, warranting further exploration. Additionally, physical or emotional stress can trigger the condition, leading to a surge in stress hormones.

Characteristics of Takotsubo Cardiomyopathy

According to Harvard Medical School, “Takotsubo cardiomyopathy is a weakening of the heart’s main pumping chamber, the left ventricle, usually as the result of severe emotional or physical stress like a sudden illness, the death of a loved one, or a natural disaster.” During takotsubo syndrome, the left ventricle experiences abnormal movements and apical ballooning syndrome. However, the rest of the heart muscle continues to function normally or even contracts vigorously. Symptoms of broken heart include sudden chest pain and shortness of breath, resembling a heart attack.

Stress cardiomyopathy often leads patients to believe they are experiencing a heart attack. An electrocardiogram (ECG) may show irregular heartbeats like those seen in heart attacks. However, the coronary angiogram of patients shows that the coronary arteries are not blocked, unlike in traditional heart attacks. Persistent chest pain should always be considered seriously because it could signal an actual heart attack.

Chest Pain and Takotsubo Cardiomyopathy

Stress cardiomyopathy frequently causes changes in electrocardiograms (ECGs) similar to those seen in heart attacks. Patients with this syndrome often experience sudden chest pain and shortness of breath, which can be mistaken for a heart attack. However, unlike heart attacks, patients’ coronary arteries are not blocked. Nonetheless, any persistent chest pain requires immediate medical attention.

Stress Cardiomyopathy and Its Causes

The exact cause of Takotsubo Cardiomyopathy is not yet fully understood, but it’s believed to be triggered by a flood of stress hormones that affect the heart. This hormonal surge disrupts blood flow and impacts the left ventricle’s ability to contract. Women past menopause are particularly vulnerable.

Intense emotional events that can precede broken heart syndrome include:

• Domestic violence
• Financial hardship
• Divorce or difficult breakup
• Death, illness, or injury of a loved one
• Public speaking
• Serious accident
• Physically demanding events

In rare cases, certain medications can cause a surge in stress hormones, potentially triggering Broken Heart Syndrome.

Heart Attack vs. Broken Heart Syndrome

While stress cardiomyopathy often resembles a heart attack due to sudden chest pain and irregular heartbeats, there is a key difference between the two. In heart attacks, blood clots can lead to blocked coronary arteries, contrasting with Broken Heart Syndrome where such blockages do not occur. In a heart attack, blocked coronary arteries prevent adequate blood flow, causing damage to the heart muscle. In Broken Heart Syndrome, a coronary angiogram shows no blocked arteries, and the heart muscle is only temporarily weakened.

Risks, Complications, and Treatment

Heartbroken syndrome risk factors include age, with those over 50 facing a higher risk. Women, especially Asian and Caucasian post-menopausal women, have a higher risk. Medical history of neurological disorders, like epilepsy, or psychiatric disorders like depression, increases the likelihood of heart syndrome. Other risk factors include emotional or physical stress.

Takotsubo cardiomyopathy can occasionally lead to fatal complications like heart failure, abnormal heart rhythms, low blood pressure, or pulmonary edema. Although most people recover in a few weeks, broken heart syndrome diagnosed may reoccur with another stressful event.

Treatment for broken heart often includes prescribing medication like beta-blockers, ACE inhibitors, or diuretics. These help prevent heart failure and reduce stress. In cases of atherosclerosis, aspirin may also be used. Patients can work with a healthcare team specializing in cardiac rehabilitation and stress management to prevent broken heart syndrome.

If you suspect you are at risk or have symptoms, reach out to an interventional cardiologist like Dr. Beheshtian at Avicenna Cardiology. She offers comprehensive care to prevent broken heart syndrome and will work with you to identify and reduce the stress that could cause takotsubo syndrome or worse outcomes like a worse prognosis.

Frequently Asked Questions (FAQ) about Takotsubo Cardiomyopathy (Broken Heart Syndrome)