Referring to a broken heart usually doesn’t signal mortal peril, but a new study has identified a condition associated with heartbreak and comparable to acute coronary artery syndrome.
“Broken-heart syndrome,” or takotsubo cardiomyopathy, causes an abnormal contracture of the heart, MedPageToday reported. “Takotsubo” is the Japanese word for an octopus trap; when the heart contracts this way, it resembles this shape.
The study, published today in the New England Journal of Medicine, looked at 1,750 American and European patients enrolled in the International Takotsubo Registry. They found that the women were nine times more likely than men to experience the condition.
When the condition was first reported in 1990, it was believed to be a largely benign, transient disorder that primarily affected older females. Takotsubo seemed to be triggered by highly stressful events, such as the death of a spouse.
"Our work widens the spectrum of the characteristics of the disease," Ghadri told MedPage. "This is still largely a disorder of postmenopausal women with emotional stressors, but we also identified patients who were male and younger. And physical stressors, such as neurologic disease, were common triggers."
Researchers found that patients had a 9.9 percent rate of major adverse cardiac events and stroke and a 5.6 percent death rate per year.
The disorder is often misdiagnosed because its symptoms are similar to those of acute coronary syndrome, such as chest pain and shortness of breath. To identify the distinctive left ventricle shape characteristic of takotsubo cardiomyopathy, clinicians must adminster a coronary angiography, but that isn’t often used, researchers noted.
The study also found that 15.3 percent of patients showed evidence of coronary artery disease with an angiography.
Takotsubo is commonly treated with beta blockers, ACE inhibitors, and diuretics, but there are no formal recommendations to guide treatment. In their study, researchers observed that the use of ACE inhibitors and angiotensin-receptor blockers improved survival rate.
"Since ours was a retrospective study, we are not sure what to make of this," Ghadri told MedPage Today. "A prospective study is needed to better define the optimal treatment for this disorder."