Broken heart syndrome/ Takotsubo Cardiomyopathy/ Apical Ballooning syndrome

Broken heart syndrome/ Takotsubo Cardiomyopathy/ Apical Ballooning syndrome

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Broken heart syndrome, also known as stress-induced cardiomyopathy or Takotsubo cardiomyopathy, is a condition where intense emotional or physical stress can cause sudden and severe heart muscle weakness or dysfunction. This condition can mimic a heart attack with symptoms such as chest pain, shortness of breath, and irregular heartbeats, but it’s not caused by blocked arteries typical of a heart attack.

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Pathophysiology: It is believed that a surge of stress hormones, such as adrenaline, may temporarily damage the heart muscle, leading to the characteristic symptoms.

 

Here are some key points about broken heart syndrome:

  1. Triggering Factors: Broken heart syndrome can be triggered by various emotional or physical stressors, such as the death of a loved one, a breakup, financial loss, a serious medical diagnosis, or even a surprise party.
  2. Symptoms: The symptoms of broken heart syndrome can resemble those of a Myocardial infarction and may include chest pain, shortness of breath, arrhythmias, and in some cases, fainting.
  3. Diagnostic Work up:
    ECG will show ST Elevation
    Troponin I will be Elevated
    Echo will show Apical Ballooning
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    Coronary angiography will be normal and not show any coronary artery occlusion by any thrombus as it does in STEMI. Therefore, it is a diagnosis of exclusion.

    Always Rule out Myocarditis and Pheochromocytoma

  4. Treatment: Treatment for broken heart syndrome usually involves supportive care to stabilize the patient and manage features of Acute CHF. Intra-aortic balloon pump is preferred over inotropes in cardiogenic shock for broken heart syndrome. Other medications to reduce the workload on the heart, such as beta-blockers, ACE inhibitors are used along with diuretics to relieve pulmonary edema. Most patients recover within a few weeks to months with appropriate medical management.
  5. Prognosis: The prognosis for broken heart syndrome is generally favorable, with most patients recovering completely without long-term complications. However, in some cases, there can be complications such as heart failure, arrhythmias, or in rare cases, death.

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