Takotsubo Cardiomyopathy or “broken heart syndrome” is a sudden, transient cardiac syndrome that causes the left ventricle of your heart to change in shape and become enlarged. The heart muscle thus weakens and is not able to pump blood as well as required of it. Takotsubo syndrome accounts for 2% of the total acute coronary syndromes worldwide.
It’s a type of stress cardiomyopathy, as the heart weakening might be triggered by emotional stress such as rejection from a partner or death of a loved one. This leads to the medical term broken heart syndrome. Patients present with chest pain, elevated cardiac enzyme levels that mimic myocardial infarction, and may show an ST-segment elevation in ECG.
The first studied case of takotsubo cardiomyopathy was presented in Japan by Sato et al in 1991.
The name “takotsubo” has come due to the resemblance of the enlarged heart to that of the Japanese “takotsubo” octopus trap. The left ventricle of the heart develops a narrow neck and a round bottom – akin to the shape of the traditional trap.
It’s not an inherited heart condition, and is known by many names – acute stress-induced cardiomyopathy are apical ballooning, takotsubo syndrome, or just takotsubo in short.
What are the causes of Takotsubo Cardiomyopathy?
Stress is the main factor, with more than 85% cases set in motion by an emotional or physical trigger. It’s more common in postmenopausal women with a recent history of severe (mostly negative, sometimes happy) emotional or physical triggers.
Common examples of physical stress are:
Common examples of emotional stress are:
There have been reports of people experiencing takotsubo after happy events like a reunion, getting married, a new job, winning a jackpot or a sporting event etc. Some also experience it after being involved in natural disasters such as an earthquake. 30% of people are able to identify the trigger that caused the condition in them.
Though the exact cause can’t be pinpointed, experts believe that surging stress hormones i.e catecholamines like adrenaline and norepinephrine “stun” the heart. This event thereby triggers changes in the heart muscle cells or the coronary blood vessels or both which prevents the left ventricle from contracting effectively.
Takotsubo Cardiomyopathy Symptoms
One can mistake this as a heart attack as the symptoms often feel similar. These are:
If you are experiencing any chest pain, shortness of breath, or rapid, irregular heartbeat, call for emergency medical services immediately.
Diagnosis of Takotsubo Syndrome
The diagnosis depends on three things:
1. If a heart attack gets excluded
2. If you’re heart muscle shows signs of damage
3. If your left ventricle changes shape
Various diagnostic tests are carried out to rule out a heart attack and definitive diagnosis of takutsubo.
Cardiac Magnetic Resonance Imaging (MRI) Scan is also used at times for differential diagnosis.
Takotsubo Cardiomyopathy Treatment
The treatment is supportive in nature as it’s a transient disease and left ventricular function normalizes within two months in many people. Aspirin is seen to be very helpful, but what’s most required is further treatment that addresses lifestyle changes. One needs to know how to cope with stress.
Your doctor might prescribe you any of the following medication:
Takotsubo Cardiomyopathy vs Reverse Takotsubo
Patients with reverse takotsubo, a rare variant of takotsubo, present with a different profile
What are the complications?
In some rare cases, the takotsubo cardiomyopathy can prove to be fatal. But most people recover quickly without any long-lasting effects. Frequent complications are:
The takotsubo syndrome ICD 10 diagnosis code is I51.81, that helps in indicating diagnosis required for medical reimbursement purposes. If you have been experiencing extreme stress and share some of the risk factors of takotsubo cardiomyopathy, consult with your physician before it’s too late.