Stress Cardiomyopathy

Stress cardiomyopathy, a mysterious condition commonly known as broken heart syndrome or takotsubo cardiomyopathy, can produceintense chest pain and other symptoms that can feel like a heart attack. In fact, about 5% of women having a heart attack actually have this condition. The good news is that most people with stress cardiomyopathy have full recovery with no long term damage to their heart.

Women are particularly vulnerable to stress cardiomyopathy. Researchers found that women are approximately 9 times more likely than men to experience stress cardiomyopathy. The majority of those affected are post-menopausal. Treatment includes consultation with a cardiologist and risk factor modification.

What Causes Broken Heart Syndrome?

The exact mechanism is not fully understood, but we think it has to do with a surge in stress hormones (like adrenaline or dopamine) in reaction to extreme emotional or physical stress, for example, learning about the sudden death of a family member, a divorce or a car accident. Fortunately, it’s almost always temporary and rarely fatal. The majority of patients recover within a month.

Stress hormones increase your heart rate, elevate your blood pressure and provide bursts of energy that in large quantities can
disrupt heart function.

What’s the Difference Between Broken Heart Syndrome and a Heart Attack?

Heart attacks are usually caused by blocked heart arteries. A blockage begins with a blood clot caused by the buildup of plaques or fatty material, a disease known as atherosclerosis, in the artery walls. The blocked artery can result in damage to the heart, reducing its ability to pump blood efficiently.

In broken heart syndrome, your heart’s arteries are not blocked but the heart’s pumping function is suddenly reduced..

Signs of Broken Heart Syndrome

Remember, this condition can closely mimic a heart attack. So look for:

• Chest pain/pressure/tightness
• Shortness of breath
• Pounding heart (palpitations)
• Dizziness
• Sweating
• Nausea, vomiting
• General weakness
• Passing out

Risk Factors

• Sex: This condition affects far more females than males. We don’t know yet why women have this condition more than men, but we do know that they become more vulnerable after menopause, with most cases occurring in postmenopausal women.
• Age: Women 55 and older are almost three times more likely than younger women to develop broken heart syndrome, according to a study.
• Mental health: A history of anxiety or depression increases your risk.

Treating Stress Cardiomyopathy

There is no standard treatment for stress cardiomyopathy, but often we use similar medications that we use to treat heart failure, particularly beta-blockers, ace-inhibitors and diuretics. Fortunately, most patients fully recover in a few weeks but we often continue medications for longer with the goal of preventing a recurrence. We also focus on modifying risk factors for heart disease.

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