BROKEN HEART SYNDROME: SYMPTOMS, TYPES AND CAUSES - ECONOMÍA - 2024

The syndrome heartbroken, also known as Tsubo syndrome, or stress - induced cardiomyopathy, is a problem of the heart usually caused because of a particularly intense emotion. Its symptoms are very similar to those of a heart attack, but its origin and physical causes are totally different.

We've all heard the expression "heartbroken." However, it was not until a few years ago that it was discovered that it was really possible to suffer from heart problems from emotional causes. Today, Takotsubo syndrome is a recognized cause for problems such as heart failure, arrhythmias, or ventricular rupture.

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This heart problem is characterized by a temporary weakening of one of its muscle walls. Because of this, one of the parts of this organ suddenly swells and stops working well; the rest, on the other hand, continue to pump with the same or even greater intensity.

In most cases, broken heart syndrome is treatable and its symptoms can be reversed. However, on some occasions it can lead to complications or even the death of the patient who suffers it. In this article we tell you everything you need to know about this peculiar heart disease.

Symptoms

The symptoms of Takotsubo syndrome are very similar to those of a myocardial infarction. Therefore, despite the existence of some fundamental differences between both ailments, it is sometimes difficult to make an accurate diagnosis of this disease.

Next we will see what are the most common symptoms of broken heart syndrome.

Chest pain and shortness of breath

This symptom is the first one that patients with Takotsubo syndrome are usually aware of. Generally, after suffering a very intense stress or anxiety situation, they feel deep pain in the chest similar to that described in the case of a heart attack.

At the same time, a large part of patients with this syndrome describe great difficulty in breathing, which in principle is not associated with the emotion previously felt.

Abnormalities in heart function

Normally, after suffering from the chest pain and breathing difficulties mentioned above, patients with broken heart syndrome go to medical services to check that there are no serious problems. It is in these cases that the second symptom can be observed.

On having an electrocardiogram (a test to study the movements of the heart), people with Takotsubo syndrome show a heart pattern similar to that of someone who has had a heart attack. This can lead to many misdiagnoses, especially since this disease is not very common.

Lack of blockage in the arteries

The main difference between broken heart syndrome and a heart attack is that in the former there is no blockage in the arteries leading to this organ. Therefore, the causes of the first two symptoms are totally different between the two diseases.

Altered cardiac enzyme levels

In addition to presenting an irregular pattern when studied by an electrocardiogram, the heart of patients with Takotsubo also usually have alterations in the levels of usual enzymes. This may be due to the presence of a less than normal amount of blood in this organ.

Left ventricle problems

What, therefore, causes the altered results on the electrocardiogram? Patients with Takotsubo syndrome present a strange alteration in the heart: due to the weakening of the muscular walls of the heart due to stress, the left ventricle swells and stops beating correctly.

It is precisely from this swelling that the technical name of the problem comes. When in its altered state, the heart takes a shape similar to that of a takotsubo, a kind of vase used by Japanese fishermen to catch octopus.

Fortunately, although it can be severe in some cases, most of the time the swelling of the left ventricle tends to subside over time. Even so, it is advisable to carry out some type of intervention to avoid complications.

Types

In principle, there is only one variant of this cardiac function disorder. In all cases, regardless of the causes for which it is caused, the symptoms are the same: problems in the way the heart beats, weakening of the muscle walls, and a bulging in the left ventricle.

However, some experts believe that depending on what causes Takotsubo syndrome, there may be some slight differences in both symptoms and prognosis.

The information that exists on this subject is still insufficient, so further research is required before any conclusion can be reached.

Causes

Today, we still don't know exactly what causes broken heart syndrome. The most plausible theory is that an extreme increase in the levels of some stress-related hormones, such as cortisol or adrenaline, is capable of temporarily damaging the muscular walls of this organ in some people.

Usually this syndrome is triggered by one of two factors: either an emotionally intense event, or the use of certain medications.

We will describe each of these possible causes below, in addition to studying the risk factors that may make developing this heart disease more likely.

Emotionally intense events

The popular name of this heart problem, "broken heart syndrome", comes from the fact that many of the cases of the same occur when the person experiences an extremely strong emotion. This is usually a negative thing, but even pleasant feelings like joy can trigger it.

Thus, among the most common causes of Takotsubo syndrome are divorces, the death of a loved one, a particularly painful breakup or a case of acute stress sustained over time; but also other more positive events like suddenly winning a lot of money (for example, the lottery) or a surprise party.

Of course, not all people who experience a very strong emotion will develop this heart function disorder. In general, a prior vulnerability is necessary for the muscle walls to weaken to such extreme points.

Medication use

In some isolated cases, an attack of Takotsubo syndrome has been triggered after the use of certain medicines to treat problems such as asthma, severe allergic attacks or even psychological problems such as major depression.

It is not yet known exactly which medications are at risk of causing an episode of this problem. However, some recorded cases have been caused by epinephrine, duloxetine, and venlafaxine.

Risk factor's

Regardless of whether the trigger for the cardiac abnormality is a strong emotional event or the use of a medication, it is known that a prior vulnerability is necessary for broken heart syndrome to occur. Some of those that most affect the chances of developing this disease are the following:

- Age. Only 3% of the cases of Takotsubo syndrome recorded throughout history have affected people under 50 years of age. According to statistics, the people most at risk of suffering from it are those between 55 and 75 years old.

- Sex. For some reason, this heart problem tends to be much more common in women than in men.

- Previous psychological disorders. Due to the effect of the emotions felt in the development of this disease, you are much more likely to suffer from broken heart syndrome if you have previously suffered episodes of depression, anxiety or similar disorders.

- Presence of neurological disorders. Those who have suffered from neurological problems (such as epilepsy or a head injury) are also more likely to develop Takotsubo syndrome.

Complications

In most of the known cases, broken heart syndrome tends to go away on its own after a while. However, on some occasions complications may appear that can endanger the well-being or even the life of the patient.

Heart failure

In approximately 20% of the cases in which this syndrome appears, the person affected by it may experience cardiovascular arrest.

In these cases, if not resuscitated immediately, irreversible damage to the patient is possible. If you do not receive medical assistance, you may die.

Extremely low voltage

Another of the most common complications of Takotsubo syndrome is a drop in blood pressure so severe that it can be life-threatening.

This is known as cardiogenic shock, and in general it is necessary to intervene in some way on the person in order to stabilize it and avoid greater risks.

However, achieving this can be difficult, since in most cases in which there is a drop in blood pressure, certain medications are usually inoculated that could aggravate the rest of the symptoms of the syndrome.

Pulmonary edema

On some occasions, the Takotsubo can cause the introduction of liquids into the lungs of the person who suffers it. This tends to be extremely dangerous, as it makes it difficult or even prevents the person from breathing.

Fortunately, this symptom is extremely rare, as well as being relatively easy to treat once detected.

Rupture of the muscular wall of the heart

Another possible complication of broken heart syndrome, and one of the most serious, literally involves tearing of the muscle wall of the swollen ventricle. If it occurs, the patient's life would be in extreme danger; but luckily, this symptom only occurs in a very small percentage of cases.

Treatments

Usually, the symptoms of Takotsubo syndrome tend to go away on their own, and will have completely resolved within a few weeks. Because of this, it is usually not necessary to apply any type of treatment to those who suffer from it so that they recover completely.

However, many cardiologists recommend following some procedures to make recovery faster, as well as to avoid possible complications.

Among other things, drugs are often given to combat cardiovascular failure, such as beta-blockers, diuretics, or ACE inhibitors.

Stress reduction

Because one of the main factors that play a role in the development of broken heart syndrome is an altered emotional state, it is often recommended that the person try to eliminate any situation that causes stress or emotional pain from their life.

For this, the patient will have to carry out changes in their lifestyle. In addition, you may need to see a mental health professional, who can help you manage your negative emotions more effectively to prevent the onset of a new episode of the syndrome.

Long term treatment

Although it is rare for a person to have two episodes of Takotsubo syndrome in their lifetime, some cardiologists choose to preventively medicate patients who have already suffered from it.

Among other things, it is recommended that these people take beta-blockers throughout their lives, to reduce the effects of adrenaline and other stress hormones in their body. However, more research needs to be done on the real benefits of this treatment.

Recovery

In most cases, people who have had an episode of broken heart syndrome are fully recovered within two months at most. However, due to the weakening of their muscle walls, they are more likely to suffer from cardiovascular disease in the future.

Even so, despite having symptoms similar to those of a heart attack and affecting a part of the body as important as the heart, this syndrome does not usually cause great difficulties in the lives of those who suffer from it. Those affected by it tend to recover their health almost completely, and do not usually suffer new episodes in the future.

References

1. "Is broken heart syndrome real?" in: Heart. Retrieved on: October 03, 2018 from Heart: heart.org.
2. "Takotsubo cardiomyopathy (broken-heart syndrome)" in: Harvard Health Publishing. Retrieved on: October 03, 2018 from Harvard Health Publishing: health.harvard.edu.
3. "Can you die of a broken heart?" in: WebMD. Retrieved on: October 03, 2018 from WebMD: webmd.com.
4. "Broken heart syndrome" in: Mayo Clinic. Retrieved on: October 03, 2018 from Mayo Clinic: mayoclinic.org.
5. "Takotsubo" in: Wikipedia. Retrieved on: October 03, 2018 from Wikipedia: en.wikipedia.org.