Most of us have heard the expression “broken heart” in reference to a time in life when a person was extremely sad, hurt, or angry because of a loss or other upsetting situation. Believe it or not, broken heart syndrome is actually a real heart condition, and one that requires medical attention.
What is broken heart syndrome?
In the medical world, broken heart syndrome is also known as stress induced cardiomyopathy, apical ballooning syndrome, and Takotsubo cardiomyopathy. The condition is characterized by weakness of the heart muscle, usually at the very tip, or apex, of the heart. This part of the heart does not squeeze or contract like it should.
A Japanese octopus trap…what??
Takotsubo is the name for a round-bottomed Japanese octopus trap. When someone experiences broken heart syndrome, the heart looks like this special pot used to catch octopus, bulging out rather than having its usual point at the apex.
Symptoms of broken heart syndrome include chest pain and shortness of breath, and can occur suddenly.
We do not know why this weakness of the heart muscle suddenly occurs. Many patients with heart muscle weakness, or heart failure, have blockage or narrowing of the heart arteries, a condition called atherosclerosis. In this situation, the heart muscle doesn’t contract well because the heart muscle cells are not getting the oxygen they need to function properly.
On the other hand, patients with broken heart syndrome do not have significant blockage of their heart arteries. Some researchers believe the weakness is brought on by a surge of stress hormones called catecholamines, like epinephrine or adrenaline.
Broken heart syndrome is rather rare. Only about 1% of patients who have symptoms such as shortness of breath or chest pain are diagnosed with this type of heart muscle weakness, or heart failure.
Who is likely to experience broken heart syndrome?
This condition is more common in older adults, especially women. Although classically associated with some sort of emotionally stressful event such as the death of a loved one or even a surprise party, we now know that it also occurs in patients who are hospitalized for other medical problems and are under physical stress. It can even occur in patients with no prior medical history or recent stressful event.
Most people with this condition are treated with medication to help the heart muscle recover function. Less than 10% of patients develop shock, but may require placement of a temporary heart pump to support their weak heart muscle and make sure their vital organs receive appropriate blood flow.
Most people recover their heart function with medication. In some cases, we recommend that they continue to take these medications for the rest of their life. About 10% of patients will have another episode of this condition. There are no specific ways to prevent this syndrome, so it is important to be aware of the symptoms and seek medical attention if you experience chest pain or shortness of breath.
Lindsay M. Castle, DO, is a cardiologist with The Heart Group of Lancaster General Health. Dr. Castle has special interest in advanced heart failure and transplant cardiology.
Education: Medical School—Ohio University College of Osteopathic Medicine; Residency—Ohio Health Doctors Hospital; Fellowships—Ohio Doctors Hospital and St. Vincent Hospital.
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