So we had this broad topic during our 2018 last Internal Medicine class -cardiomyopathy for which one of the types of cardiomyopathy is “Takotsubo Cardiomyopathy” also known as “broken heart syndrome”. It’s an interesting type for the student presenter made us laugh, and ofcourse the guys are the defaulters here( the feminine side of me defending the ladies) because they break ladies heart all the time and sure boom Takotsubo Cardiomyopathy happens.
Takotsubo cardiomyopathy TCM, also known as stress cardiomyopathy is a type of non-ischemic cardiomyopathy characterized by 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, rejection from a partner or constant anxiety.
A significant emotional or physical stressor or neurologic injury typically precedes the development of the TCM. Identified stressors of broken heart syndrome include the following:
Learning of a death of a loved one
Bad financial news especially for entrepreneurs out there.
Legal problems especially those people who use words like “I will sue you or you will hear from my lawyer” easily.
Motor vehicle collisions.
Exacerbation of a chronic medical illness
Newly diagnosed significant medical condition
Intensive care unit (ICU) stay
Use of or withdrawal from illicit drugs
- Sudden drop in blood pressure
- Serious illness, surgery, or medical procedure (e.g., cardiac stress test)
- Severe pain
- Domestic violence
- Asthma attack
- Receiving bad news (such as a diagnosis of cancer or “custom esizela ngwa ahia” for my Igbo people)
- Unexpected loss, illness, or injury of a close relative, friend, or pet (I can relate to loss of pet when my caucasian and mixed breed dogs died, I was so heartbroken)
- Fierce argument
- Intense fear
- Public speaking( let me go and ask my friend if this is the reason she doesn’t like class presentation)
- A surprise party or other sudden surprise( for all these surprise surprise people, make sure a health personal is around to handle the situation if it arises but not withstanding I love surprise goodies)
- Constant Anxiety
- Rejection from a partner
- Break-up from relationship
TCM has also been reported after near-drowning episodes. Seizures may also trigger TCM, but it is rare for TCM to result in sudden unexpected death in epilepsy (SUDEP).
Features of Takotsubo Cardiomyopathy
- Chest pain and shortness of breath after severe stress (emotional or physical).
- Electrocardiogram abnormalities that mimic those of a heart attack.
- No evidence of coronary artery obstruction.
- Movement abnormalities in the left ventricle.
- Ballooning of the left ventricle.
- Recovery within a month.
Diagnosis of Broken Heart Syndrome
To get a definitive diagnosis, clinicians look for the following:
- No evidence on an angiogram of blockages in the coronary arteries — the most common cause of heart attacks.
- A rapid but small rise in cardiac biomarkers (substances released into the blood when the heart is damaged). In a heart attack, cardiac biomarkers take longer time to rise but peak higher.
- An echocardiogram (ultrasound image) or other imaging technique that shows abnormal movements in the walls of the left ventricle.
- The most common abnormality in broken heart syndrome (takotsubo cardiomyopathy) — the one that gives the disorder its name — is ballooning of the lower part of the left ventricle (apex). During contraction (systole), this bulging ventricle resembles a tako-tsubo, a pot used by Japanese fishermen to trap octopus.
Treatment of Broken Heart Syndrome
There are no evidence-based guidelines for treating broken heart syndrome (takotsubo cardiomyopathy). Clinicians usually recommend standard heart failure medications such as beta blockers, ACE inhibitors, and diuretics (water pills). They may give aspirin to patients who also have atherosclerosis (plaque buildup in the arterial walls). Although there’s little evidence on long-term therapy, beta blockers (or combined alpha and beta blockers) may be continued indefinitely to help prevent recurrence by reducing the effects of adrenaline and other stress hormones. It’s also important to alleviate any physical or emotional stress that may have played a role in triggering the disorder.
Heparin or enoxaparin
Platelet glycogen (GP) IIb/IIIa inhibitors
Prevention of broken heart syndrome
- Avoid all risk factors mentioned above especially the matters of the heart.
- Uncles and aunties kindly stop breaking each others heart to avoid this Takotsubo Cardiomyopathy, it’s real but people don’t die from it except your heart has been “chronically broken”.
Usual disclaimer: This is just an awareness that something like broken heart syndrome exists.
Stay Healthy and love filled.