Broken Heart Syndrome

Takotsubo Cardiomyopathy is a condition of the heart that leads to a weakened left ventricle. Takotsubo cardiomyopathy can be recognized by a number of names such as; Stress-Induced cardiomyopathy, Apical Ballooning Syndrome and most commonly (and fun to say) Broken Heart Syndrome. Takotsubo Cardiomyopathy gets its name from the Japanese Octopus traps, TakoTsubo, similar to the clay pots you would smash in Zelda. During Broken Heart Syndrome, the left ventricle becomes weakened and since the left ventricle is the chamber of the heart that is responsible for doing most of the pumping work, when this becomes damaged, or weakened, movement in the left ventricle becomes abnormal and it becomes enlarged and starts to balloon out at the apex, giving it the clay pot shape. “The exact pathogenesis of TCM (Takotsubo Cardiomyopathy) is unknown, but various hypotheses have been suggested and discussed, including coronary microvascular dysfunction, coronary artery spasm, catecholamine-induced myocardial stunning, reperfusion injury following acute coronary syndrome, myocardial microinfarction and abnormalities in cardiac fatty acid metabolism. Currently, catecholamine-induced cardiotoxicity and microvascular dysfunction are the most supported theories” (Komamura et al, 2014). Although it is generally believed that excessive stress changes the muscle memory in the coronary blood vessels, which prevent the left ventricle from functioning properly. Signs and symptoms of Broken Heart Syndrome are similar, if not identical to those of a heart attack. Individuals experiencing broken heart syndrome will feel chest pain, shortness of breath, and may feel arrhythmias and cardiogenic shock occur. 7“Cardiogenic shock is a condition in which a suddenly weakened heart can’t pump enough blood to meet the body’s needs, and it can be fatal if it isn’t treated right away.” (American Heart Association) Though the tell tale signs are identical between broken heart syndrome and heart attack, there are many ways to diagnose broken heart syndrome. Electrocardiogram results differ between heart attack and broken heart syndrome, blood work would show no elevation in cardiac enzymes, and various forms of imaging can be used to confidently diagnose broken heart syndrome as they can provide a visual of the ballooning at the apex as well as abnormal movement in the left ventricle. General treatment of broken heart syndrome is pretty straightforward in the sense that the individual should alleviate stress; straightforward, not simple. Overall, treatment for broken heart syndrome is not definitive, and there is not sufficient evidence for long-term therapy, but improvement of general health is always the first step and “physicians recommend common heart failure medications such as beta blockers, ACE inhibitors, diuretics and therapeutic aspirin.” (Harvard Health Publishing). The individual is also instructed to alleviate any emotional and physical stress that could be contributing to the damage in addition to preventing the recurrence effects of adrenaline from occurring regularly. Death by broken heart syndrome is rare, however, it does increase the risk for heart failure which, left unmonitored, could pose a significant threat to the individual. With the correct treatment, someone suffering from broken heart syndrome can have their symptoms resolved within a couple of weeks to a couple of months.