Broken Heart Syndrome (Takotsubo Cardiomyopathy) Quiz

Broken heart syndrome, also called takotsubo cardiomyopathy or stress-induced cardiomyopathy, is a condition in which the heart muscle enlarges in response to stressors, such as an unexpected death, a fight, exhausting work, or a mental or emotional trauma.

Stress can cause a rush of catecholamines into a person’s system. This rush of stress hormones may cause enlargement (dilation) of the left ventricle in a person’s heart. The dilation of the ventricle causes dysfunction on the heart function.

A number of stressors are associated with triggering broken heart syndrome, such as:

• Unexpected loss, illness, or injury of a close relative, friend, or pet
• Sudden drop in blood pressure
• Serious illness, surgery, or medical procedure (e.g., cardiac stress test)
• Severe emotional or physical stress
• Domestic violence
• Receiving bad news (such as a diagnosis of cancer)
• Car or other accident
• Fierce argument

Symptoms of broken heart syndrome include:

• Chest pain
• Shortness of breath
• Feeling of anxiety
• Nausea
• Back pain
• Palpitations
• Sweating

Call 911 and get to a hospital's emergency department (do not drive yourself) if you experience any of these symptoms.

In response to stress, the muscle of the heart enlarges. When dye is introduced to the heart to evaluate its function, the left ventricle has a characteristic appearance of a balloon, or a Japanese octopus fishing pot called a takotsubo.

The heart dysfunction in broken heart syndrome is caused by the left ventricle enlargement, and not a blocked artery as would be seen in a heart attack. Symptoms can be similar between takotsubo cardiomyopathy and a heart attack, but the cause is not the same.

More than 90% of cases of broken heart syndrome affect postmenopausal women. Some research suggests that up to 5% of women diagnosed with a heart attack may actually have takotsubo cardiomyopathy.

Broken heart syndrome is diagnosed with an electrocardiogram (EKG) that shows abnormalities in the blood flow to the left ventricle. These EKG changes can mimic the changes seen with an acute heart attack. A cardiac catheterization ("cardiac cath") is used to determine if there are any coronary artery blockages. An echocardiogram ("echo") is used to assess the dilation and function of the left ventricle. Other tests such as blood tests for heart muscle damage, infection, and levels of stress hormones can also help confirm the diagnosis.

No specific treatment is needed for broken heart syndrome. The condition usually goes away on its own. If the heart dysfunction is severe, patients may require diuretics or other heart medications. Patients with abnormal heart rhythms in takotsubo cardiomyopathy may benefit from magnesium sulfate. Estrogen can also be beneficial in elderly women with the condition.

The recovery time for broken heart syndrome is usually one to two months. It is rare that there are long-term problems from the ventricle dysfunction. Some patients with severe dysfunction may require medications to help improve heart function, but the disorder usually resolves on its own.

Broken heart syndrome can be fatal but it is rare. Between one to eight percent of patients who are hospitalized with takotsubo cardiomyopathy may die from the condition. About 20% of patients will suffer from heart failure. Complications of the condition are rare and may include arrhythmias, obstruction of blood flow from the left ventricle, and ventricle wall rupture. However, the majority of cases will recover completely within one to two months with no complications or lasting effects.