Symptoms include chest pain, difficulty breathing, and sudden loss of consciousness.
Takotsubo cardiomyopathy most often affects women between the ages of 61-76. The condition commonly occurs immediately after experiencing extreme emotional or physical stress.
Research suggests that the sudden release of stress hormones temporarily "stuns" and weakens the heart. This stunning leads to inadequate circulation of blood throughout the body.
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Here are some key points about takotsubo cardiomyopathy. More detail and supporting information can be found in the main article.
- Takotsubo cardiomyopathy was first identified in 1990
- The condition is named after a Japanese trap for octopuses
- People with takotsubo cardiomyopathy often mistake it for a heart attack
- Doctors believe that the condition is caused by the sudden release of stress hormones
- Takotsubo cardiomyopathy can be set off by emotional events
- Symptoms can include nausea, irregular heartbeat and sweating
- Takotsubo cardiomyopathy is diagnosed with the same tests as a heart attack
- The condition is usually treated with a short stay in a hospital
- Most people recover from takotsubo cardiomyopathy within 1-2 weeks
- Life-threatening complications occur in less than 5% of cases.
What is takotsubo cardiomyopathy?
Takotsubo cardiomyopathy occurs most often among women aged 50 and over.
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" - 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. It occurs most often in women 50 years of age and older.
Most individuals with takotsubo cardiomyopathy seek emergency treatment because of concern they are 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.
Causes of takotsubo cardiomyopathy
Although the exact cause of the syndrome is not known, research suggests that the sudden release of stress hormones (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.
Although over one-quarter of individuals (28.5%) have no clear triggers, takotsubo myopathy is typically triggered by an unexpected emotionally or physically stressful event.
Events that could trigger takotsubo cardiomyopathy include:
- The sudden death of a loved one
- Domestic abuse
- Natural disasters
- Motor vehicle accident
- 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.
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, on one occasion, trigger this condition, when at another time, a similar event does not.
Also, experts do not yet know why it is primarily older women that have takotsubo cardiomyopathy. Gender differences in the heart's sensitivity to stress hormone toxicity could be influential. Deficiency in estrogen activity may also be important.
Symptoms of takotsubo cardiomyopathy
The most common symptoms of takotsubo cardiomyopathy are:
- Chest pain
- Difficulty breathing
- Irregular heartbeat
- Loss of consciousness or fainting.
These symptoms begin a few minutes to hours after exposure to the unexpected stress.
Because there is no way of knowing if these symptoms are from a heart attack (acute myocardial infarction) or takotsubo cardiomyopathy, they should be treated as an emergency.
Tests and diagnosis of takotsubo cardiomyopathy
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 done with contrast dye in a hospital's cardiac catheterization laboratory.
Treatment for takotsubo cardiomyopathy
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 may be given drugs that reduce blood clotting. Taking these drugs can help avoid a stroke.
Monitoring takes place in the intensive care unit for at least 24 hours. People with takotsubo cardiomyopathy often need a total hospital stay of 3-7 days.
Commonly used medications to treat takotsubo cardiomyopathy include beta-blockers and angiotensin converting enzyme (ACE) inhibitor drugs. These drugs promote recovery of heart muscle.
Drugs that interfere with blood clotting (anticoagulants) may be administered briefly to avoid a stroke.
Complete recovery occurs within 1-3 months.
Antianxiety or beta-blocker medication therapy may be given 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.
The majority of people with takotsubo cardiomyopathy recover within 1-2 weeks.
Life-threatening complications occur in less than 5% of cases and can include:
On rarer still 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.
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Takotsubo cardiomyopathy is a temporary heart condition where an abrupt, unpredictable stressful event causes the heart to suddenly fail, producing symptoms similar to those of a heart attack.
The disorder is not caused by underlying heart disease but is thought to be due to toxic effects of stress hormones on the heart muscle and cardiac blood vessels. With timely recognition, supportive therapy, and medical follow-up, the majority of individuals with takotsubo cardiomyopathy recover quickly and sustain no long-term heart damage.