Takotsubo cardiomyopathy, or broken heart syndrome, is a rare, life-threaten-ing condition. It's called broken heart syndrome because some form of emotional or physical distress often precedes it. The actual cause of the condition, which almost always strikes women, is unknown. The condition was originally diagnosed in Japan and has been seen in the US only in recent years. Patients are usually critically ill during the first 48 hours, and it often appears that they're having a heart attack. However, there is no sign of coronary artery blockage.

A Better Way

These patients can be difficult to manage. They may be in cardiac arrest, cardiogenic shock, or severe heart failure. They may require advanced life support with airway management and meditations to support blood pressure," said Brown University cardiology fellow Dr. Richard Regnante.

A registry developed by Regnante and colleagues at Brown University in Providence, Rhode Island, currently includes 40 patients diagnosed with Takotsubo cardiomyopathy at two major Rhode Island hospitals over a span of 21/2 years. Of those patients, 95% were women, and 60% experienced a stressful event—ranging from armed robbery to a major argument, tooth extraction, or preparation for colonoscopy—before they went to a hospital emergency room for treatment of broken heart syndrome.


The most common symptom among the patients was chest pain (70%), followed by shortness of breath (33%). All patients showed electrocardiographic (ECG) changes suggestive of an acute coronary syndrome, a term that encompasses both heart attack and unstable angina.

The registry data also show that a blood test for heart damage was positive in 95% of the patients. Cardiac catheterization detected heart motion abnormalities in all the patients. One patient died of acute heart failure.

Most patients who survived the first 48 hours experienced steady recovery, and heart func-tion was found to be normal in 29 of the 30 patients who had follow-up echocardiography within a few weeks.

"We don't know why some women develop this syndrome after what appears to be minimal stress, while other women experience severely stressful events but don't develop Takotsubo cardiomyopathy,' Regnante said.

It's likely that a surge of stress hormones is a factor. It's also possible that a blood dot temporarily blocks a major artery but then dissolves before doctors can detect it.

Registry Helpful

Whatever the causes, researchers say this national registry will help doctors more easily recognize and treat this rare, life-threatening condition.

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