Sunday, 13 March 2016

Takotsubo Cardiomyopathy, (A Broken Heart?)

 When I was a young lad eavesdropping on my parents and other adults I would sometimes hear them speak of people who  died from a 'broken heart'.  It may have been in reference to someone who lost a child, a spouse, a lover or almost anyone loved deeply.  Talk of a broken heart, in fact, was not that rare to the ears of a child whose comprehension was awakening in the disastrous years of WW2.  As one grew older and matured one came to realize that the term was metaphorical and  there was no such thing as a broken  heart.  Some people certainly die from stress and suffering, pain and depression and loss of  the will to live.  But a broken heart?

   Well, in  the 90's a cardiac condition was recognized in Japan and subsequently in the U.S. and has now wide recognition.  There were 300 journal articles published in 2010.

   Symptoms of heart failure with an ECG that is suggestive of a myocardial  infarction (heart attack) is a common presentation, so this is easily misdiagnosed.  Chest pain and shortness of breath may occur.  Stress, physical or emotional is considered to be the main factor.  Grief, as from the death of a  loved one, fear, anger are frequently included among the triggers.  

   The exact cause of the myopathy is unknown, but is thought to be associated with certain types of coronary artery spasms.  The heart muscle takes on an atypical ballooning effect.

   While unattended the condition can have serious consequences, most patients recover fully with supportive in-hospital care.

    Incidentally, the stressor can be an exceptionally happy event, like winning the lottery, so be careful!

    Shape assumed during contraction is supposed to resemble Japonese Octopus pots (Takotsubo) after which  the disease is named.

    So perhaps people have been dying of a broken heart since the beginning of time?

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