Takotsubo cardiomyopathy or Broken heart syndrome.Â
Takotsubo cardiomyopathy is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart and this weakening can be triggered by emotional stress, such as the death of a loved one, a break-up, or constant anxiety.
The typical presentation of takotsubo cardiomyopathy is a sudden onset of congestive heart failure associated with ECG changes mimicking a myocardial infarction of the anterior wall. During the course of evaluation of the patient, a bulging out of the left ventricular apex with a hypercontractile base of the left ventricle is often noted (apical ballooning). It is the hallmark bulging out of the apex of the heart with preserved function of the base that earned the syndrome its name “tako tsubo”, or octopus pot in Japan, where it was first described.
Stress is the main factor in takotsubo cardiomyopathy, over 85% of cases are set in motion by either a physically or emotionally stressful event that prefaces the start of symptoms.
The treatment of takotsubo cardiomyopathy is generally supportive in nature. Since the disease is due to a high catecholamine state, patients should not be given inotropes. Treatment recommendations include intra-aortic balloon pump, fluids, and negative inotropes such as beta blockers or calcium channel blockers. In many individuals, left ventricular function normalizes within 2 months. Aspirin and other heart drugs also appear to help in the treatment of this disease, even in extreme cases.
Despite the grave initial presentation in some of the patients, most of the patients survive the initial acute event, with a very low rate of in-hospital mortality or complications.
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