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
    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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