Broken heart syndrome , also called “stress-induced cardiomyopathy” or “takotsubo cardiomyopathy,” can affect anyone , even healthy people without any predisposition to heart disease.
It should be noted that “tako tsubo” is the Japanese name for some traps used to capture octopuses , which have a shape similar to that seen in a heart that suffers from this condition. The syndrome was described in Japan in the 90s, it is called “broken heart” because it is associated with triggers such as acute emotional changes , for example unexpected deaths, breakups, job losses, among other emotional stressors.
This syndrome is characterized by physical symptoms that produce anginal precordial pain, electrocardiographic changes, elevated enzymes that indicate myocardial damage, and characteristic anteroapical dyskinesia of the left ventricle . This syndrome is characterized by an absence of coronary obstruction in the acute phase, anteroapical dyskinesia with reversible basal hyperkinesia, and typical electrocardiographic evolution. It generally normalizes within a few days and is not a serious disease . However, full attention and care must be given. necessary.
The typical clinical presentation of Takotsubo syndrome is all indications of a myocardial infarction , anginal precordial pain, and electrocardiographic changes. Both manifestations are a consequence of ventricular dysfunction, which manifests on ECG with Q waves and ST/T changes. Although this pathology has been described since the 1980s, it has not been until recently that its vasospastic nature has been confirmed, and therefore the origin and treatment have been variable and very particular in each case, which would indicate a exhaustive study of each particular case.
There are some treatments for Takotsubo syndrome, such as stress and anxiety management in those patients with a history of post-traumatic stress, anxiety disorders and mood disorders, among others.
Cognitive behavioral therapies and those techniques and currents that can help the patient deal with recurring thoughts or all those symptoms that can cause excessive stress have also been tested.
With acute myocardial infarction (AMI) in general, there are factors that predispose it to have this side effect , such as arterial hypertension, diabetes mellitus, obesity, peripheral vascular pathologies, and smoking.
Therefore, it can be avoided with medical control and healthy habits of the patient , good nutrition, regular sleep, avoiding smoking and alcohol, reducing distressing symptoms .
The prevalence of this cardiomyopathy is 1-3% of all patients with suspected coronary syndrome and 6-9% if only women are taken into account. It has been described that patients with tako tsubo cardiomyopathy are at increased risk of generalized anxiety disorder or have a psychiatric family history that predisposes the person to suffer from the syndrome.
Although the typical precipitants of this disease are negative stressful events, it has recently been associated with positive emotions, because it can also be triggered by high variations in serotonin loads , which is the hormone responsible for producing well-being in certain regions of the brain.
Likewise, an association has been found between tako-tsubo cardiomyopathy and neurological (7%) and psychiatric (24%) disorders, among which anxiety disorders (13%) , mood disorders (9%) and delirium or dementia (2%) .
One of the mechanisms by which an attempt has been made to explain this association supposes that the anxious patient is subjected to constant chronic psychological stress which, in a situation of acute stress, triggers the syndrome; of course, hormonal alterations would have to be studied such as oxytocin loads affect the same as serotonin changes and produce the predisposition to suffer from the disorder.
Stress-related mechanisms that can promote myocardial dysfunction include activation of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system, serotonergic dysfunction, secretion of proinflammatory cytokines, and platelet activation.
It has also been proposed that the presence of psychosocial factors , such as a family history of depression and anxiety or social isolation, play an important role in the appearance of this disease, evidently that being subjected to very intense emotional loads will predispose to people to suffer from the syndrome.
In this order of ideas, it should be noted that the “tako tsubo” syndrome is predominant in women, one of the most questioned issues in this prevalence is that women have a predisposition to emotional alteration and fluctuation in view of the fact that they suffer from many more hormonal changes than men, although it is not an exclusive prevalence of sex, but most cases occur in women in pre-menopausal stage or installed menopause.