The “broken heart“ syndrome

Yes, it is for real and there is real science behind it. It is called “Takotsubo cardiomyopathy” (TTC) named after a Japanese octopus trap basket by the Japanese scientists who first described it. The trap resembles closely the abnormal shape of the ventricle in TTC patients. Other terms applied to this condition are left ventricular apical ballooning syndrome or stress-induced cardiomyopathy or neurogenic myocardial stunning. TCC is thought to be rare because in many cases, Takotsubo is mistakenly diagnosed as an acute coronary syndrome as the main symptom is chest pain or angina. Other signs are changes in ECG readings, mildly elevated cardiac enzymes and wall motion abnormalities.

What cause a heart to break?

An intensely emotional or stressful event can trigger TCC. Mayo Clinic cites the following examples:

• ·         News of an unexpected death of a loved one
• ·         A frightening medical diagnosis
• ·         Domestic abuse
• ·         Losing a lot of money
• ·         A surprise party
• ·         Having to perform publicly
• ·         Physical stressors, such as an asthma attack, infection, a car accident or major surgery

Are women more likely to have a broken heart?

The answer is “yes.” The broken heart syndrome is more common in women that in men. Several cases have been reported in women right after C-section delivery, possibly in connection with severe postpartum depression. It has also been reported in postmenopausal women. Cases were also reported among the elderly who suffered from abuse. In a nutshell, those who are at high risk for a broken heart are women who are 50 or older and may suffer from domestic abuse.

How can you detect a broken heart?

The electrocardiogram (ECG) can detect abnormalities that can indicate TCC. However, an imaging tool may be necessary to confirm the diagnosis based on the abnormal structure of the ventricle. This can be through echocardiogram or cardiac CT.

How can you mend a broken heart?

The same drugs that are prescribed for angina and acute coronary syndrome (angiotensin-converting enzyme (ACE) inhibitors, beta blockers or diuretics) may be prescribed for TCC. The good thing about TCC or broken heart syndrome is that it is transient (not permanent) and the recovery rate is high. Plus, you are most likely to get it only once, according to Singaporean researchers. Could it be that a heart cannot be broken twice?

Check out these resources:

• ·         Koulouris et al. Takotsubo Cardiomyopathy: The “Broken Heart” Syndrome. Hellenic J Cardiol 2010; 51: 451-457.
• ·         Broken heart syndrome, Mayo Clinic

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