A heart attack occurs when a clot or blockage causes the heart muscle to die. At least, that's what we've always known. But Japanese researchers may have discovered another kind of heart attack. They've called it "takotsubo cardiomyopathy" and it's being refered to in English as stress cardiomyopathy or "broken heart syndrome." The Japanese name for this form of heart attack comes from the shape the heart takes during an attack, resembling a type of octopus pod. But what is it?
Unlike in the traditional heart attack, stress cardiomyopathy doesn't involve clots or blockage. It's believed to be the response to intense phyiscal or emotional distress. Physical stress can be anything from an asthma attack to chemotherapy. The emontional stress can be major, like the death of a relative, or it can be minor, like a surprise birthday party. The symptoms are typical of a heart attack: chest pain, shortness of breath, and low blood pressure. But the heart muscle isn't dying; instead it is becoming very weak, like another group of conditions of the heart called cardiomyopathy.
The weakness is caused by a flood of adrenelin that makes the heart collapse into the distinctive shape that the Japanese researchers noticed. Since there's no physical blockage, the condition doesn't need bypass surgery like with most heart attacks. In fact, the patient can get better in a few days if supported through the attack. There's no abnormal EKG, blocked arteries seen in an angiogram, or blood test results consistant with a heart attack. Most victims of this atypical heart attack are post-menopausal women. It is rarely fatal, and almost never occurs more than once in a patient. Some drugs can cause broken heart syndrome: Epinephrine, used to treat severe allergic reactions, Cymbalta, an anti-depressant and diabetes drug, Effexor XR, another anti-depressant, and thyroid medications Synthroid and Levoxyl.
Since the symptoms are impossible to distinguish from typical heart attacks, anyone who suspects they may have it should receive emergency treatment immediately. Once stress cardiomyopathy is diagnosed (usually by ruling out a tradtional heart attack with the tests mentioned above) it can be treated. There might be an aortic pump used, fluids given, or aspirin taken during the first few days, before the heart starts to correct itself. Complications include pulmonary edema and heartbeat irregularities, which are treated with medication. Anti-anxiety drugs or beta blockers may be prescribed, but they usually won't have to be taken for extended periods of time.
[Image via Wikipedia/J. Heuser]