Tako-Tsubo syndrome: Definition?
Tako-Tsubo, also known as stress-induced cardiomyopathy, broken heart syndrome or apical ballooning syndrome, is a condition characterised by sudden weakening or shock of the heart muscle. It usually occurs after extreme physical or emotional stress. Most people recover from the condition in two months or less, and it is usually temporary.
Different types of broken heart syndrome
There are four different types of broken heart syndrome:
- Apical: This is the most common type, accounting for over 80% of cases. It affects the lower part of the heart.
- Midventricular: This type affects the middle segment of the lower ventricles, forming a belt or ring around the heart. The areas above and below the belt continue to function normally.
- Basal: Similar to midventricular, the affected area resembles a ring or belt, but is located higher up. Only the area below the belt functions normally. This type is extremely rare, accounting for about 2% of cases.
- Focal: This is the rarest type, accounting for about 1% of cases. It affects a smaller area than the other types, creating a visible bulge that stands out from the rest of the heart. The opposite side of the heart curves inwards towards the bulge.
What causes Tako-Tsubo?
The exact cause of Tako-Tsubo is not fully understood, but it is generally accepted that it is a reaction to stress. When the body is under intense stress, it releases large amounts of hormones such as adrenaline and noradrenaline. These hormones can cause the heart muscle to contract excessively, leading to damage.
Emotional events that can trigger broken heart syndrome include :
- Loss of a loved one
- divorce
- Separation
- An accident
- Assault
- Natural disaster
- Loss of job
Broken heart syndrome is more common in women than in men (about 9 women to 1 man), especially in postmenopausal women. It is also more common in older people and those with risk factors for heart disease, such as :
- High blood pressure
- Diabetes
- Smoking
- Obesity
- Alcohol abuse
Symptoms of broken heart syndrome
The symptoms of Tako-Tsubo syndrome, which mirror those of a heart attack, include a range of distressing manifestations that provide a comprehensive insight into the physiological upheaval experienced by those affected by this condition. These symptoms include
- Chest pain or pressure that may radiate to the left arm, jaw or shoulder
- Sudden shortness of breath
- Loss of consciousness
- Vasovagal reaction
- Heart palpitations
In addition, the origin of the symptoms, whether due to emotional shock or not, and the menopausal state in a female patient may immediately suggest broken heart syndrome. Rapid intervention is essential as early diagnosis can prevent potentially serious cardiac complications and allow appropriate patient management.
Diagnosing Tako-Tsubo cardiomyopathy
A healthcare professional will carry out a physical examination and review your medical history. He or she may then order several tests, including :
- A blood test to check for a specific enzyme released by damaged heart muscle cells.
- Coronary angiography
- Electrocardiogram (ECG)
- Echocardiography
- Chest X-ray
- Magnetic resonance imaging of the heart (MRI)
- Ventriculography
What is the treatment for apical bloating?
Although there is no cure for Tako-Tsubo cardiomyopathy, or broken heart syndrome, most patients make a full recovery with medication.
The following medications are used to treat broken heart syndrome:
- Aspirin to improve blood circulation and prevent the formation of clots in blood vessels
- ARBs (angiotensin receptor blockers) or ACE (angiotensin converting enzyme) inhibitors to reduce blood pressure and prevent inflammation
- Beta blockers, which reduce heart rate
- Diuretics to reduce fluid accumulation
