Broken heart syndrome is a rare disease that causes symptoms similar to those of a heart attack, such as chest pain, shortness of breath, dizziness, vomiting or tiredness.
The most common cause of this syndrome is intense emotional or physical stress, due to a separation process or after the death of a family member, for example, mainly affecting women after 50 years of age. However, it can also affect people of any age, including men.
The treatment of broken heart syndrome, also known as Takotsubo cardiomyopathy or stress cardiomyopathy, is carried out by a cardiologist using medicines that help regulate cardiac activity and psychological support.
Symptoms of Broken Heart Syndrome
The main symptoms of broken heart syndrome are:
- Chest pain;
- Shortness of breath or difficulty breathing;
- Fainting;
- Heart palpitation;
- Irregular heartbeat;
- Dizziness and vomiting;
- Excessive tiredness.
The symptoms of broken heart syndrome usually appear after a situation of great physical or psychological stress and may disappear without treatment.
However, when symptoms appear, you should immediately go to the emergency room to begin the most appropriate treatment, as these symptoms are similar to those of a heart attack.
How to confirm the diagnosis
The diagnosis of broken heart syndrome is made by a cardiologist through evaluation of symptoms, health history, blood tests and tests that assess heart health.
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Thus, the main tests that may be ordered by the doctor are a complete blood count with platelets and cardiac biomarkers, such as troponin, creatine phosphokinase-MB (CK-MB) and brain natriuretic peptide (BNP), for example.
Other tests that may be requested by the doctor are electrocardiogram, chest X-ray, magnetic resonance imaging, heart radionuclide scintigraphy or cardiac catheterization, for example. See other heart exams.
These tests help to exclude conditions with similar symptoms, such as heart attack, acute coronary syndrome, coronary artery spasm, myocarditis or pericarditis, for example, and confirm the diagnosis of broken heart syndrome.
Possible causes
The exact cause of broken heart syndrome is not completely known, but it is known that psychological and physical factors can trigger the symptoms.
The main factors that can increase the risk of broken heart syndrome are:
- Unexpected death of a family member or friend;
- Diagnosis of serious illness;
- Financial or gambling problems;
- Separation process;
- Domestic violence;
- Accidents or serious traumas;
- Natural disasters.
These conditions can lead to an increased release of adrenaline, norepinephrine and dopamine in the body and result in spasms in the coronary arteries, microvascular dysfunction and damage to the heart muscle.
Additionally, the use of drugs such as cocaine or amphetamines can also increase the risk of broken heart syndrome.
Read too: Coronary artery disease: what it is, symptoms and treatment
tuasaude.com/doenca-coronariana
How the treatment is carried out
The treatment of broken heart syndrome must be guided by the cardiologist or general practitioner at the hospital, using medication and monitoring vital and hemodynamic data to avoid complications.
Thus, the main treatments that may be recommended by the doctor are:
- Antiplatelets, such as acetylsalicylic acid;
- Beta blockers, to normalize heartbeat;
- ACE inhibitors, to lower blood pressure;
- Medicines to reduce cholesterol;
- Diuretics, to help eliminate swelling due to failure of the heart to pump;
- Angiography to assess whether there is coronary obstruction.
In some cases, placement of an intra-aortic balloon pump or left ventricular assist devices may be necessary.
After recovery, follow-up with a psychologist and/or psychiatrist may be recommended in order for the person to overcome the trauma and emotional stress. Check out other ways to overcome stress.
Possible complications
The main complications of broken heart syndrome are cardiogenic shock, ventricular arrhythmias, atrial fibrillation, left ventricular obstruction, heart failure or thromboembolism.
These complications can be life-threatening and, therefore, when symptoms of broken heart syndrome appear, you should immediately go to the hospital to begin the most appropriate treatment.
Read too: Cardiogenic shock: what it is, symptoms, causes and treatment
tuasaude.com/choque-cardiogenico
Bibliography
- AMIN, HZ; et al. Takotsubo Cardiomyopathy: A Brief Review. J Med Life. 13. 1; 3-7, 2020
- AHMAD, SA; BRITO, D.; KHALID, N.; ET AL. IN: STATPEARLS (INTERNET). TREASURE ISLAND (FL): STATPEARLS PUBLISHING. Takotsubo Cardiomyopathy. 2023. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK430798/>. Accessed on January 24, 2024
- BOYD, B.; SOLH, T. Takotsubo cardiomyopathy: Review of broken heart syndrome. JAPA. 33. 3; 24-29, 2020
- HOEKSTRA, Bianca E. et al. Takotsubo Disease (Broken Heart Syndrome): an Underdiagnosed Disease?. Rev Bras Cardiol. Vol.27, n.5. 327-332, 2014
- HARVARD HEALTH PUBLISHING. Takotsubo cardiomyopathy (broken-heart syndrome). Disponível em: <https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome>. Acesso em 24 fev 2020
- AMERICAN HEART ASSOCIATION. Is Broken Heart Syndrome Real?. Disponível em: <https://www.heart.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults/is-broken-heart-syndrome-real>. Acesso em 24 fev 2020
- UPTODATE. Clinical manifestations and diagnosis of stress (takotsubo) cardiomyopathy. Disponível em: <https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-stress-takotsubo-cardiomyopathy?search=Takotsubo%20Syndrome&source=search_result&selectedTitle=1~91&usage_type=default&display_rank=1>. Acesso em 24 fev 2020
