Japan's Broken Heart Syndrome

Leslie Lafayette Health Guide March 23, 2011
  • In the aftermath of the terrible events in Japan, I have been thinking about a heart condition called "Takotsubo Cardiomyopathy."  It is also nicknamed "Broken Heart Syndrome." If has been said that you can die of a broken heart, or die of fright, but is it true?

     It can be, but it is uncommon.

    First identified in Japan in the 1980s, the takotsubo is almost always identified with post menopausal women.  It can happen for no reason at all, but usually follows a very emotional event -  death of a family member, an appearance in court, a heated argument, even the end of a love affair. And certainly, an earthquake and a tsunami. 

    If you go to your doctor or ER with symptoms of a takotsubo, the first thing medical personnel will suspect is a heart attack, as this condition mimics everything about a heart attack including changes in EKG and blood chemicals.  Nearly two years ago, after a stressful meeting which I found difficult to attend, I found myself bathed in perspiration and noticed some discomfort in my arm and chest when I was walking into a store.  I ascribed it to the warm summer day and aftermath of an aggravating afternoon. That evening, I felt all right, but the next day I continued to have pain in my upper back and chest area, which felt more muscular than heart related. Late in the day I agreed to go to the local Urgent Care, was given an EKG and immediately transported by ambulance to the ER where I was told my first blood tests showed I had a heart attack.  Only after an echocardiogram (an important diagnostic tool for this condition) and an angiogram to rule out a blockage did my cardiologist confirm what he had suspected all along. This was no heart attack. Instead, my heart had been temporarily "stunned" by chemicals released after stress, chemicals we have little control over, which constrict the small vessels feeding the heart. Our hearts respond with a temporary heart failure of sorts, a ballooning of the bottom of the left ventricle (the heart takes on the appearance of a Japanese octopus pot, which is narrow at the top and wide at the bottom) and some abnormal wall motions. With time, rest, and sometimes an adjustment in medications, most who experience a takotsubo recover and the condition is unlikely to recur.

    Although research indicates this condition is rare, I personally disagree. In my case, I waited a day and almost did not go to the clinic. As it turned out, had I stayed home, thinking I was just tired, it is likely that I would have recovered and never known what had happened. I think a lot of women tend to ignore their symptoms or ascribe them to stress or exhaustion. Thus, these events don't get reported. However, it is much wiser to check out any unusual symptoms that might relate to the heart and get medical support. Some takotsubo situations can be dangerous and even fatal. If you meet the criteria - likely a woman, post menopausal, with recent history of a stressful life event - and you are experiencing chest discomfort, arm or shoulder pain, nausea, diaphoresis (heavy perspiring) or trouble breathing, seek immediate medical help.

  • It may be a broken heart syndrome, but remember... broken hearts can be healed.