Broken heart syndrome
| Takotsubo cardiomyopathy | |
|---|---|
| Synonyms | transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, Gebrochenes-Herz-Syndrom, broken-heart syndrome |
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| Schematic representation of takotsubo cardiomyopathy (A) compared to a normal heart (B) | |
| Classification and external resources | |
| Specialty | Cardiology |
| ICD-10 | I42.8 |
| ICD-9-CM | 429.83 |
| DiseasesDB | 33976 |
| eMedicine | article/1513631 |
| MeSH | D054549 |
Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart. This weakening may be triggered by emotional stress, such as the death of a loved one, a break-up, or constant anxiety. This leads to one of the common names, Broken Heart Syndrome. Stress cardiomyopathy is now a well-recognized cause of acute heart failure, lethal ventricular arrhythmias, and ventricular rupture.
The name "Takotsubo syndrome" comes from the Japanese word for a kind of octopus trap (), because the left ventricle takes on a shape resembling a fishing pot.
The typical presentation of Takotsubo cardiomyopathy is a sudden onset of chest pain associated with ECG changes mimicking a myocardial infarction of the anterior wall. During the course of evaluation of the patient, a bulging out of the left ventricular apex with a hypercontractile base of the left ventricle is often noted. It is the hallmark bulging out of the apex of the heart with preserved function of the base that earned the syndrome its name "tako tsubo", or octopus pot in Japan, where it was first described.
Stress is the main factor in Takotsubo cardiomyopathy, with more than 85% of cases set in motion by either a physically or emotionally stressful event that prefaces the start of symptoms. Examples of emotional stressors include grief from the death of a loved one, fear of public speaking, arguing with a spouse, relationship disagreements, betrayal, and financial problems. Acute asthma, surgery, chemotherapy, and stroke are examples of physical stressors. In a few cases, the stress may be a happy event, such as a wedding, winning a jackpot, a sporting triumph, a reunion, or a birthday.
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