Takotsubo syndrome mimics the symptoms of "myocardial infarction, so much so that to distinguish it from the latter" and diagnose it, several investigations are needed (clinical history, physical examination, electrocardiogram, echocardiogram, coronary angiography, etc.).
More frequent in menopausal women, Takotsubo syndrome requires hospitalization and a series of treatments aimed at relieving the workload of the heart and improving symptoms.
Rarely, Takotsubo syndrome results in complications; in fact, in general, the people who are affected are able to recover completely within a month.
To prevent Takotsubo syndrome, knowing how to manage stress can be essential.
Takotsubo syndrome is an example of non-ischemic cardiomyopathy: cardiomyopathy, because it is characterized by an anatomical modification of the myocardium accompanied by an "alteration in the functioning of the heart; not ischemic, because there are no interruptions to the blood flow to the myocardium.
Takotsubo syndrome is also known as broken heart syndrome (for the connection to emotional / stressful situations), heartbreak syndrome and stress cardiomyopathy.
Who Discovered Takotsubo Syndrome?
The first descriptions of Takotsubo syndrome date back to the early 90s of the twentieth century and belong to a Japanese research team.
These descriptions report evidence according to which strong stress or emotions can affect the health of the myocardium and trigger a mostly temporary suffering for him.
Why is it called that?
"Takotsubo" is a Japanese word and refers to a kind of pot / basket used by Japanese fishermen to catch octopuses.
The researchers who first described Takotsubo syndrome thought they gave this curious name to the suffering in question, because, on echocardiographic or magnetic resonance images, the patient's left ventricle takes on a shape very similar to the takotsubo for fishing for fish. octopuses.
It is important to underline that Takotsubo syndrome only affects people who are in some way predisposed: this is why not all people who experience deep emotion or strong stress develop the heart disease in question.
Did you know that ...
With regard to the appearance of Takotsubo syndrome, it should be noted that there are theories according to which the dysfunction of the myocardium is also due to a temporary vasoconstriction of the coronary arteries or to their dysfunction, always temporary.
The main Triggers of Takotsubo Syndrome
Observing the various clinical cases, the stressful or emotional situations most associated with Takotsubo syndrome are:
- The death of a loved one;
- The diagnosis of a very serious disease;
- Domestic violence;
- The loss or winning of large sums of money;
- Surprise parties;
- Public speaking;
- Job loss and financial problems;
- Separation or divorce;
- Physical stresses such as asthma attacks, bone fractures or major surgery.
Other Takotsubo Syndrome Triggers
It should be noted that, in the "list of potentials triggers Takotsubo syndrome also includes the intake of drugs, such as epinephrine, duloxetine, venlafaxine and levothyroxine, whose effect is to raise the levels of adrenaline and / or noradrenaline in the body; this circumstance also represents a sort of confirmation of the causal role played by catecholamines in the onset of the broken heart syndrome.
Did you know that ...
For reasons yet to be established, Takotsubo syndrome is more common in winter; moreover, again for unclear reasons, it affects people with epilepsy more easily.
What distinguishes Takotsubo syndrome from heart attack?
Unlike a heart attack, in Takotsubo's syndrome the coronary arteries are patent, unblocked; this means that they do not have atheromas within them that prevent blood flow (which is what happens in the onset of myocardial infarction. ).
Epidemiology
According to some estimates, in the countries of the Western World, Takotsubo syndrome affects 2-3% of all people who show symptoms of a heart attack; this means that it is an uncommon condition.
Furthermore, other statistical research on Takotsubo syndrome has shown that the latter is more frequent in the female population (90% of cases involve a woman), especially in menopausal women (probably due to hormonal reasons).
Most women with Takotsubo syndrome are between 58 and 75 years old; only 3% of female cases concern women under the age of 50.
sudden and sharp;The similarity in terms of symptoms between Takotsubo syndrome and myocardial infarction is an aspect that is by no means negligible, especially when it comes to diagnosis.
Complications
Typically, Takotsubo syndrome is a temporary condition with no long-term repercussions. In some rare circumstances, however, it can happen that it becomes a serious heart condition, responsible for complications, such as pulmonary edema, hypotension, arrhythmias and even cardiac arrest; in the latter circumstance, broken heart syndrome can be fatal.
Can Takotsubo syndrome come back?
As a result of another stressful and highly emotional situation, Takotsubo syndrome can recur again; however, this is a rather unusual occurrence.
When to see a doctor?
The sudden and apparently unreasonable appearance of symptoms such as chest pain and shortness of breath is always a valid reason to call 911 and seek immediate medical assistance.
coronary);Such an accurate diagnostic process is essential to distinguish Takotsubo syndrome from "myocardial infarction, a condition, the latter, with decidedly more severe consequences for human health."
What differentiates Takotsubo Syndrome from Heart Attack?
In Takotsubo syndrome:
- Sudden onset symptoms usually occur after a stressful event or strong emotion; this characteristic emerges from the patient's clinical history.
- Cardiac activity measured by ECG is altered, but not as in myocardial infarction.
- Blood tests do not detect appreciable quantities of enzymes indicative of damage to the myocardium, damage and consequent enzymes that are instead typical of heart attack; to learn more, we recommend the article dedicated to cardiac enzymes present here.
- The coronary arteries are not blocked; this finding is ascertainable through coronary angiography.
- The left ventricle, observed on echocardiography and magnetic resonance imaging, shows dilation and contractile activity absent in the case of myocardial infarction.
Once the diagnosis is made, therefore, the therapy focuses on the intake of drugs such as ACE inhibitors, beta-blockers, diuretics and angiotensin receptor antagonists, with the aim of "lightening" the workload of the heart ( who is temporarily not in perfect health) and improve the symptoms present (eg: counteracting hypotension).
After an episode of Takotsubo syndrome, drug intakes, especially those based on beta-blockers, could be long-term.
Takotsubo syndrome does not require coronary angioplasty procedures with a stent (stent coronary artery) and not even surgical interventions such as coronary artery bypass grafting: these invasive treatments, in fact, are used only in the case of myocardial infarction characterized by obstruction of the coronary arteries.
Stress management
Doctors strongly advise patients who have suffered from Takotsubo syndrome to consult an expert in relaxation and stress management techniques, so that they can learn how to deal properly with the most emotionally intense and stressful situations.
and meditation (eg yoga), sports and the practice of an alternative hobby to working life.
