Takotsubo cardiomyopathy is a temporary heart condition that is brought on by stress. It has the same symptoms as a heart attack but is not caused by any underlying cardiovascular disease.
It is also known as stress cardiomyopathy, apical ballooning, or broken heart syndrome.
Takotsubo cardiomyopathy most often affects women between the ages of 61 and 76 years. The condition commonly occurs immediately after experiencing extreme emotional or physical stress.
Takotsubo cardiomyopathy was first identified in Japan in 1990 and is now reported worldwide.
It was named “takotsubo” cardiomyopathy because during the acute phase of the syndrome, the left ventricle bulges and takes on a balloon shape. This shape is similar in appearance to the Japanese fisherman’s tako-tsubo, meaning an octopus trap.
Takotsubo cardiomyopathy starts abruptly and unpredictably, with symptoms of chest pain, shortness of breath, and fainting.
The condition is usually triggered by an emotionally or physically stressful event and is most often seen in women between the ages of 61 and 76 years.
Most individuals with takotsubo cardiomyopathy seek emergency treatment because of concerns that they may be experiencing a heart attack. Although it has similar symptoms to a heart attack, individuals with takotsubo cardiomyopathy show no evidence of blocked coronary arteries, and recover quickly.
A person with takotsubo cardiomyopathy needs supportive care in a hospital setting until left ventricular function is restored to the heart.
People with takotsubo cardiomyopathy often need to stay in hospital for between 3 and 7 days.
Medications commonly used to treat takotsubo cardiomyopathy include beta-blockers and angiotensin converting enzyme (ACE) inhibitor drugs. These drugs promote heart muscle recovery.
Anticoagulant drugs that interfere with blood clotting may be administered to avoid a stroke.
Complete recovery usually occurs within 1 to 3 months.
Anti-anxiety or beta-blocker medication may be prescribed for a longer period of time to help control the release of stress hormones. It is also important to alleviate or manage the stress that may have played a role in triggering the disorder.
Life-threatening complications can include:
On even rarer occasions, takotsubo cardiomyopathy can lead to death.
Close follow-up care with a cardiologist is necessary, as the long-term effects of takotsubo cardiomyopathy are still unknown.
The disorder is not caused by underlying heart disease but is thought to occur due to the toxic effects of stress hormones on the heart muscle and cardiac blood vessels.
With early diagnosis, supportive therapy, and follow-up treatment, the majority of individuals with takotsubo cardiomyopathy recover quickly and sustain no long-term heart damage.
Although the exact cause of the syndrome is not known, research suggests that the sudden release of stress hormones, such as norepinephrine, epinephrine, and dopamine, “stuns” the heart.
Stunning the heart triggers changes in heart muscle cells and coronary blood vessels.
This hormone effect weakens the left ventricle, preventing it from pumping much-needed, oxygen-rich blood throughout the body.
Events that could trigger takotsubo cardiomyopathy include:
- the sudden death of a loved one
- domestic abuse
- natural disasters
- a motor vehicle accident
- a fierce argument
- relationship conflicts
- severe financial or gambling losses
- being diagnosed with a medical condition
- exhausting physical effort
- acute medical illness
- head trauma
- public speaking
- extreme fright
Cases of takotsubo cardiomyopathy have also been reported after cocaine use, excessive stimulant drug use, or during opiate withdrawal.
People with certain mood disorders
Some instances of takotsubo cardiomyopathy have occurred after positive stressful events, such as winning the lottery or a surprise party.
It is not understood why a specific stressful event will trigger this condition, but at a similar event may not do so at a different time.
Also, experts do not yet know why it is primarily older women that have takotsubo cardiomyopathy. A drop in estrogen activity may be a contributing factor in older women.
The most common symptoms of takotsubo cardiomyopathy are:
- chest pain
- difficulty breathing
- irregular heartbeat
- loss of consciousness or fainting
These symptoms begin between a few minutes and a few hours after exposure to the unexpected stress.
As there is no way of knowing if these symptoms are from a heart attack or takotsubo cardiomyopathy, they should be treated as an emergency.
The tests and procedures for takotsubo cardiomyopathy are similar to those used to diagnose a heart attack. These tests include various blood tests, electrocardiogram (EKG), and echocardiography.
A diagnosis is confirmed with cardiac angiography, an X-ray of the blood vessels performed with contrast dye in a cardiac catheterization laboratory.