How Broken Heart Syndrome manifests itself

Separations and deaths, but also great joy can weigh so heavily on the heart that it literally breaks. Doctors speak of Broken Heart Syndrome. Those are the first signs.

Initially, everything points to a heart attack: people with broken heart syndrome – also known as Takotsubo syndrome – have typical symptoms such as tightness and pain in the chest or shortness of breath. Even the blood count shows an increased level of certain enzymes – a classic indication of an infarction.

A closer look at the muscle, for example with the help of a heart catheter, shows that there are no relevant blockages in the coronary arteries, as is the case with a heart attack. Heart muscle damage also does not occur in broken heart syndrome. It is estimated that around two percent of patients are diagnosed with a heart attack, which is a broken heart syndrome.

Takotsubo Syndrome is believed to be triggered by an excess of stress hormones in the body. Doctors therefore also refer to the syndrome as stress cardiomyopathy. The muscles in the heart cramp as a result of the stress hormones. The main pumping chamber enlarges and the organ can no longer pump properly.

Broken heart syndrome is often hereditary

The causes of Takotsubo syndrome have not yet been clearly clarified. However, researchers now agree that there are also genetic reasons why someone is at increased risk. Certain people are more likely to suffer such an incident because their heart cells are more sensitive to stress hormones.

In addition, the pumping disorder occurs more frequently if it has already occurred in the family. There are cases worldwide in which several family members, mostly siblings or twin siblings, have suffered from broken heart syndrome. Such seizures also occur repeatedly in five to ten percent of patients, which also suggests genetic involvement.

Especially women are affected

It is striking that the disease occurs in about 90 percent of cases in women beyond the menopause. In this phase of life, the loss of a partner is more common, which can be a trigger for broken heart syndrome.

Excessive emotional reactions, both good and bad, can be a reason for pump dysfunction. If, for example, a lottery win or a wedding was the trigger, it is called happy heart syndrome. Heavy physical stress such as operations or accidents can also trigger Takotsubo syndrome.

The Takotsubo Syndrome

The clinical picture of Takotsubo syndrome was first described in the 1990s by the Japanese doctors Keigo Dote and Hikaru Sato. It is named after a traditional Japanese squid trap in the form of a bulging clay jar with a narrowed neck. The peculiar shape of the left ventricle at the end of systole, which is reminiscent of this, was considered by physicians to be the result of a circulatory disorder in the heart muscle.

The acute phase can be very dangerous

If the broken heart syndrome occurs, those affected must be monitored immediately in intensive care, because the functional disorder in the heart can trigger what is known as cardiogenic shock. In this case, the heart pumps so little blood through the body that the organism is no longer sufficiently supplied with blood and oxygen. That can end deadly.

Such shock is also a known cause of death after severe heart attacks. However, studies have shown that patients who survive cardiogenic shock have an increased risk of death. Long-term observation is therefore particularly necessary in this group of patients.

Once the acute phase is over, the majority of patients recover from the incident within a few weeks or months without any sequelae.

An operation is not necessary. With Takotsubo syndrome, doctors only ensure that the stress hormone load in the body decreases. Patients are given medication that reduces hormones. They are also given beta blockers to calm the heart.

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