Broken Heart Syndrome: When Your Heart Breaks—Literally
Broken Heart Syndrome, or takotsubo cardiomyopathy (named after the Japanese tako-tsubo pot, an octopus trap which shape resembles that of the heart of patients with this condition), is a reversible cardiomyopathy that is typically preceded by a stressful emotional, physical, or psychological event such as the death of a loved one. For that reason, this condition is also known as acute stress-induced cardiomyopathy.
This disease is a form of acute left ventricular dysfunction characterised by dilatation of the left ventricular apex and adjacent myocardium, with associated left ventricular impairment. The mechanism is poorly understood but may involve noradrenergic coronary vasoconstriction and acute left ventricular outflow obstruction. It is often associated with acute environmental or emotional stress (such as a bereavement) and presents with chest pain, breathlessness and sometimes cardiac failure. It occurs more frequently in women than in men.
In terms of both symptoms and the ECG, the condition mimics acute ST elevation acute coronary syndrome. The diagnosis is usually made at coronary angiography, when CAD is found to be absent or minimal. Echocardiography then shows the characteristic ‘apical ballooning’ of the LV. The dilated apex and narrow outflow of the LV resemble a Japanese octopus trap, or takotsubo.
Left ventricular dysfunction usually recovers within 4–5 days, although this can take weeks in some cases. Treatment is with a β-blocker, to prevent arrhythmia, and an ACE inhibitor, to treat left ventricular dysfunction. These drugs are continued only until cardiac function has recovered. It’s also important to alleviate any physical or emotional stress that may have played a role in triggering the disorder.
In medical terms, the word “heart” may refer to the muscular, blood-pumping organ in the human body instead of the metaphorical “center of a person’s thoughts and emotions, especially love or compassion.” However, our physical and emotional or psychological health are not mutually exclusive. To take good care of our body is to take good care of our mind and well-being.
“Synergizing Diversity, Thriving in Unity”
Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L. 1., Jameson, J. L., & Loscalzo, J. (2015). Harrison’s principles of internal medicine (19th edition.). New York: McGraw Hill Education.