Separation, death, existential fear or extreme happiness – emotional stress can cause heartbreak. This is meant literally and describes a disease in which the heart suffers from large dysfunction. This is called Takotsubo syndrome and is also called "broken heart syndrome".
At first, everything points to a heart attack. People with Takotsubo syndrome have typical symptoms such as tightness and chest pain or shortness of breath. Even the picture of blood shows an increase in the number of certain enzymes – a classic indication of infarction. However, closer examination of the muscles using a heart catheter reveals that there are no relevant blockages from coronary vessels, as is the case with infarction. Heart muscle damage also does not occur in Broken Heart Syndrome. It is estimated that two percent of patients diagnosed with a heart attack are Broken Heart Syndrome.
It is believed that Takotsubo syndrome is triggered by excess stress hormones in the body. Therefore, doctors also talk about stress cardiomyopathy in the syndrome. As a result of stress hormones, the muscles in the heart cramp. The main pump room increases and the organs can no longer pump properly.
Broken heart syndrome is often hereditary
The cause of the Takotsubo syndrome is still unclear. However, researchers now agree that there are also genetic reasons whether someone carries an increased risk. For example, certain people are more likely to experience such events because their heart cells are more sensitive to stress hormones. In addition, it often comes to pumping disorders, if it has already occurred in the family. For example, there are cases throughout the world where some family members, most siblings or twins, have suffered from Broken Heart Syndrome. In five to ten percent of patients, such seizures occur repeatedly, which also shows genetic involvement.
Especially women are affected
It is surprising that this disease occurs in about 90 percent of cases in women outside menopause. In this phase of life, it is more likely to lose a partner, which can be a trigger for Broken Heart Syndrome. Excessive emotional reactions, good or bad, can be reasons for disrupting pumping functions. If, for example, lottery victory or marriage is the trigger, Happy Heart Syndrome is pronounced. Even severe physical stress such as surgery or accidents can trigger Takotsubo syndrome.
The clinical picture of Takotsubo syndrome was explained for the first time in the 1990s by Japanese doctors Keigo Dote and Hikaru Sato. Its name is the trap of a traditional Japanese octopus in the form of a sticky clay jug with a narrowed neck. The strange shape of the left ventricle at the systole, which reminded him, was considered by the medical profession as a result of impaired heart muscle circulation.
Source: German Center for Cardiovascular Research e. V.
The acute phase can be very dangerous
If Broken Heart Syndrome occurs, those affected should be monitored for intensive care, because dysfunction in the heart can cause so-called cardiogenic shock. In this case, the heart pumps very little blood throughout the body so that the organism is no longer enough with blood and oxygen. This can be deadly. Such a shock is also a known cause of death after a severe heart attack. Patients who survived cardiogenic shock, however, had an increased risk of death, as shown by the study. Therefore, long-term observation is needed especially for this group of patients.
After the acute phase ends, most patients recover from the incident in a few weeks or months without sequelae.
This is how Broken Heart Syndrome is treated
Operation not needed. In Takotsubo, doctors only ensure that the body's stress hormone levels decrease. In addition, patients are given drugs that reduce hormones. They also get beta-blockers to calm their hearts.
Broken Heart Syndrome is more common than previously thought
In recent years, it has been found that Broken Heart Syndrome has so far not been as severe as previously thought. "Today we assume that three to five percent of all patients suspected of having a heart attack do not experience infarction, but stress cardiomyopathy," said Prof. Dr. med. Ingo Eitel, Cardiologist at the Heart Center of Lubeck.
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