Broken heart syndrome (also known as takotsubo cardiomyopathy or stress cardiomyopathy) happens when a person experiences sudden and intense stress or emotional changes, causing the heart muscle to weaken very quickly. Various life events such as losing a loved one, extreme sadness or happiness can bring about this condition.
The weakened heart is unable to pump properly. This results in symptoms which can mimic a heart attack or heart failure. This condition usually responds well to medication and recovery is expected with time.
Broken heart syndrome might be prevented through better stress and emotional management. Making lifestyle changes and seeking help when necessary can help reduce unnecessary stress, and decrease the chances of developing broken heart syndrome.
The exact cause of broken heart syndrome is unknown. It is generally thought to be caused by a surge of stress hormones, such as adrenaline, that suddenly causes the heart to temporarily enlarge, decrease the pumping action and possibly restrict one or more of the coronary arteries.
Broken heart syndrome tends to happen after intense physical or emotional events. Some examples of such events include:
In some rare cases, the use of certain drugs or medications might also lead to broken heart syndrome.
Broken heart syndrome is different from a heart attack. A heart attack is usually caused by acute cessation of blood flow in one of the coronary arteries due to blood clots formed on a ruptured cholesterol plaque. In broken heart syndrome, the arteries are not blocked but blood flow in the arteries may be reduced.
Even though the exact cause of broken heart syndrome is unknown, there are certain risk factors that might increase one’s chances of getting it. These include:
Age: Those who are above the age of 50, especially post-menopausal women, are at higher risk of getting broken heart syndrome. The exact reason for this is not known, but it is thought that the female hormone oestrogen helps to protect the heart from any harmful effects of adrenaline. When women go through menopause, their oestrogen levels decrease, thus increasing their risk of developing this condition.
Gender: Women are more likely than men to have broken heart syndrome.
Past or current mental health disorders: Those with a history of mental health disorders such as anxiety or depression have a higher risk of developing broken heart syndrome.
The doctor will perform an initial evaluation on the patient before ordering tests to check for broken heart syndrome.
Electrocardiogram (ECG): This measures your heart’s electrical activity which can differentiate between broken heart syndrome and a heart attack.
Coronary angiography: This is a minimally invasive test which is done to rule out the possibility of a heart attack. A dye will be injected into the blood vessels of the heart before moving X-ray images are taken. Patients suffering from a heart attack often have obstructions in their blood vessels, which can be seen in the X-ray. However, those suffering from broken heart syndrome usually do not have blocked blood vessels.
Echocardiogram: This is an ultrasound scan for assessment of heart function.
Cardiac Magnetic Resonance Imaging (MRI): This creates detailed images of the heart structure, and may help to differentiate broken heart syndrome from other conditions that can cause a weak heart function.
Since there is no standard treatment for broken heart syndrome, the management strategy would follow that of a heart attack until the doctor is able to ascertain that one is having broken heart syndrome.
Once verified that it is due to broken heart syndrome, doctors may prescribe medications to help the heart pump better and reduce stress on the heart until the heart recovers. Managing stress using relaxation techniques can also be very useful for recovery.
Surgical procedures used for heart attacks, such as angioplasty or coronary artery bypass surgery, are not necessary as there is usually no blockage in patients with broken heart syndrome.
