Broken heart syndrome (takotsubo cardiomyopathy or stress-induced cardiomyopathy) is a condition in which the heart muscle enlarges in response to stressors, such as an unexpected death of a loved one or pet, a fight, exhausting work, or mental or emotional trauma.
It is called takotsubo cardiomyopathy because when the dye is introduced to the heart to evaluate its function, the left ventricle has a characteristic appearance of a Japanese octopus fishing pot called a takotsubo.
More than 90% of broken heart syndrome cases affect postmenopausal women, and up to 5% of women diagnosed with a heart attack may actually have takotsubo cardiomyopathy.
Most people survive broken heart syndrome. The condition can be fatal but it is rare: about one to eight percent of patients hospitalized with the condition may die and about 20% of patients will suffer from heart failure. Most patients diagnosed with broken heart syndrome will recover completely within one to two months with no complications or lasting effects.
What Are Symptoms of Broken Heart Syndrome?
Symptoms of broken heart syndrome include:
- Chest pain
- Palpitations
- Shortness of breath
- Feeling of anxiety
- Nausea
- Back pain
- Sweating
- Dizziness
Call 911 and get to a hospital’s emergency department (do not drive yourself) if you experience any of these symptoms.
What Causes Broken Heart Syndrome?
Stress can cause a rush of stress hormones called catecholamines into a person’s system which may cause enlargement (dilation) of the left ventricle in a person’s heart. The dilation of the ventricle causes dysfunction of the heart function.
Several stressors are associated with triggering broken heart syndrome, such as:
- Grief related to unexpected loss, illness, or injury of a close relative, friend, or pet
- A sudden drop in blood pressure
- Serious illness
- High fever
- Stroke
- Seizure
- Difficulty breathing (such as an asthma attack or emphysema)
- Significant bleeding
- Low blood sugar
- Surgery or medical procedures (e.g., cardiac stress test)
- Severe emotional or physical stress
- Fear
- Extreme anger
- Domestic violence
- Receiving bad news (such as a diagnosis of cancer)
- Car or other accident
- Fierce argument
How Is Broken Heart Syndrome Diagnosed?
In addition to patient history and physical examination, broken heart syndrome is diagnosed with tests such as:
- Electrocardiogram (EKG) to check for abnormalities in the blood flow to the left ventricle
- Cardiac catheterization (“cardiac cath”) to determine if there are coronary artery blockages
- Echocardiogram (“echo”) to assess the dilation and function of the left ventricle
- Blood tests for heart muscle damage, infection, and levels of stress hormones
What Is the Treatment for Broken Heart Syndrome?
There is no specific treatment needed for broken heart syndrome and the condition usually goes away on its own.
If the heart dysfunction is severe, patients may require diuretics or other heart medications. Patients with abnormal heart rhythms in takotsubo cardiomyopathy may benefit from magnesium sulfate. Estrogen can also be beneficial in elderly women with the condition.
Some patients with severe dysfunction may require medications to help improve heart function, but the disorder usually resolves on its own.
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