Broken-Heart Syndrome

Broken-heart syndrome, also known as stress induced cardiomyopathy or Takotsubo cardiomyopathy is a condition first recognized in Japan in the 1990s.

Virtually indistinguishable from a heart attack both in signs, symptoms and clinical presentation, the condition presents as dysfunction of the heart with normal coronary anatomy, or no significant coronary blockages. The symptoms of Takotsubo cardiomyopathy, like a heart attack, include:

  • Substernal chest pain
  • Pain or numbness down the left and/or right arms
  • Sweating and/or pain or numbness up to the jaw.

Markers of heart damage, electrocardiography and echocardiography all mimic a heart attack as well. In fact, one-to-two percent of all heart attack presentations are found to be Takotsubo cardiomyopathy. Because it is impossible to tell the difference between a heart attack and broken-heart syndrome, most patients will require a coronary angiogram to ensure the patient does not have blockages in his or her coronary arteries.

A cardiologist will conduct an angiogram, which uses catheters to evaluate the coronary arteries of the heart, and can open certain types of blockages with a stent. While it is unclear exactly what causes this condition, stress, whether emotional or physical, can lead to a surge in catecholamines, a hormone made by adrenal glands as a reaction to stress. This is the body’s fight or flight response, which can lead to the abnormal cardiac function and symptoms.

Beyond a heart attack, other rare conditions can mimic broken-heart syndrome, such as a pheochromocytoma, also known as PCC, which is an abnormal tumor that produces catecholamines, or myocarditis, which is an infection in the heart itself. Treatment of this condition is largely based on symptoms, including medications to help control blood pressure and to relax the stress on the heart. Some patients may require blood thinners to prevent or treat blood clots that can develop in the heart.

The good news is that the prognosis of broken-heart syndrome is usually excellent, and most patients have a full recovery in one-to-four weeks, if detected.