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Takotsubo cardiomyopathy was first described in Japan in 90s.
The name is derived from an octopus trap used in Japan because there is a ballooning of the lower part of the left ventricle of the patients that resemble those traps called Takotsubo.
It occurs almost exclusively in women and the risk of developing it increases after the age of 55 however the exact reason for this is unknown. Death is rare, but heart failure occurs in about 20% of patients.
Takotsubo cardiomyopathy is a weakening of the left ventricle, the heart's main pumping chamber, most commonly as a result of severe emotional or physical stress.
Despite the fact that the exact pathophysiology is not known, this syndrome occurs when the cascading of catecholamines lead to changes in the cardiac system, particularly the coronary arterial system and/or the cardiac cells. The physiologic response produced by catecholamines plus the large influx of adrenaline may lead to narrowing the arteries supplying the cardiac muscle. It appears that adrenaline’s effects on the heart are temporary and completely reversible.
There are two main types of stressors – physical and emotional. The most common emotional triggers are death of a loved one, relationship conflicts, fear, anger, and anxiety. Some of the physical ones are stroke, high fever, severe pain, car or other accident, etc.
People experiencing broken heart syndrome frequently have normal coronary arteries that do not suffer severe blockages or clots and their heart cells are stunned by hormones.
It is also visible a rapid and small rise in cardiac biomarkers while in a heart attack, this rise takes longer and the peaks are higher.
As there is no standard treatment for Takotsubo cardiomyopathy, it is often recommended to use standard heart failure medications such as beta blockers - known to block catecholamine excess. The treatment will also depend on the symptoms and their severity. Additionally, some other relevant data are taken into consideration such as the blood pressure.
References
Boyd, Brenton; Solh, Tia (2020). Takotsubo cardiomyopathy. Journal of the American Academy of Physician Assistants, 33(3), 24–29. doi:10.1097/01.jaa.0000654368.35241.fc
Mahajani V, Suratkal V. Broken Heart Syndrome. J Assoc Physicians India. 2016 Jun;64(6):60-63. PMID: 27739268.
Marshall, L. S. (2016). Broken heart syndrome. Journal of Radiology Nursing, 35(2), 133–137. https://doi.org/10.1016/j.jradnu.2016.04.002
Templin C, Ghadri JR, Diekmann J, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373(10):929-938.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/broken-heart-syndrome
https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome
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