Broken-Heart Syndrome – Disease of the Month?

Ever heard of Tako Tsubo? It’s the Japanese name for the broken heart syndrome, aka left ventricular dysfunction or apical cardiomyopathy. I prefer Tako Tsubo; after all, the Japanese first reported the condition, and it’s descriptive – the malfunctioning ventricles make the heart look like a narrow-necked flask, or a Japanese octopus trap.

Tako Tsubo occurs almost exclusively in post-menopausal women who have experienced severe emotional stress, which causes the brain to release high doses of stress hormones; these paralyze some of the muscle cells of the heart, so it can’t pump blood properly. The symptoms (chest and arm pain) and signs (ECG changes, elevated heart muscle enzymes) mimic those of a myocardial infarction (MI, heart attack). The true diagnosis comes when the patient goes to the cath lab and the typical abnormal-functioning heart is viewed on the monitor.

There’s no specific treatment, just cardiovascular support – control the heart rate, raise the blood pressure, and plenty of rest. In a week or two, everything should be back to normal.

Just recently there’s been a report that the syndrome can occur after abrupt withdrawal of the opioid drug OxyContin, or after cocaine use. Maybe that’s why it’s being seen more often these days . . .