Broken heart syndrome also called “Tako Tsubo” is a cardiac emergency that mainly affects women who have gone through menopause or who have had a hysterectomy. Discovery with Dr. Claire Mounier-Vehier, cardiologist.
the broken heart syndromeWhere Tako Tsubois a cardiac emergency that affects more often women than men: approximately 9 women for 1 man, particularly those who are postmenopausal or have had a hysterectomy. 1500 people are victims each year in France. Definition, causes, symptoms, treatments, diagnosis, sequelae… Insights with Professor Claire Mounier-Véhier, cardiologist.
Definition: what is broken heart syndrome?
“Broken heart syndrome is a acute heart muscle disease which occurs following intense stress and causes a sudden secretion of stress hormones, catecholamines. The latter will attach themselves to the small specific receptors of the micro vessels of the heart and the cardiac muscle and lead to paralysis of the heart. The good news is that it is a reversible form of heart failure“ explains Professor Claire Mounier-Véhier, cardiologist. This disease is also called Tako Tsubo : “This is the name of a octopus trap in Japanese. It was the Japanese who were the first to describe this syndrome in the 1990s. Why this name of “broken heart” syndrome? “The heart is as if stunned, paralyzed and unable to function as a pump and to contract.”
Can Tako Tsubo Syndrome Cause Cardiac Arrest?
“In a Tako Tsubo, the heart is flabbergasted, paralyzed, and can no longer perform its role as a pump. This can lead to serious ventricular arrhythmias, and cardiac arrest. Cardiac arrest is a extremely serious complication, a consequence, broken heart syndrome, inform the cardiologist. “That’s why broken heart syndrome is an absolute heart emergency.”
What causes broken heart syndrome?
The main cause of broken heart syndrome is acute mental or physical stress. “The people concerned are often menopausal and anxious women, who feel stress on a daily basis” explains Pr Claire Mounier-Véhier. “Furthermore, the Covid-19 has multiplied by 5 the number of Tako Tsubo cases because the pandemic has generated stress.” It is enough “too much stress” for the person to trigger a Tako Tsubo: “There is one event too many thataccumulates to fatigue and the emotional fragility which leads to broken heart syndrome. Thus, hormones from the catecholamine family (note: adrenaline, noradrenaline and dopamine) are suddenly released. They will attach themselves to the small receptors of the micro vessels of the heart and the cardiac muscle, which will lead to paralysis of the heart. This “too many events” can be a breakupthe job lossburglary, surgical intervention… But it is not not necessarily a negative event : “It can be love at first sight, a marriage proposal for example, in these cases we can speak of a happy heart syndrome.”
What are the symptoms of broken heart syndrome?
“Tako Tsubo can manifest clinically in the same way as myocardial infarction or acute pulmonary edema” explains Professor Claire Mounier-Véhier, cardiologist. It can cause these symptoms:
- The chest pain and the feeling of oppression: “The pain in the vice in the chest, similar to that of a heart attack, is the first symptom suggestive of a Tako Tsubo.”
- A want to vomit.
- A jaw pain.
- A pain in the arm.
- Symptoms suggestive of a acute pulmonary edema : “The person may feel as if they are suffocating.”
- Of the throbbing sensations.
What to do in case of broken heart syndrome?
It’s about a heart emergency. So, if a person experiences the symptoms of broken heart syndrome, “You must immediately call 15 or 112 so that the support is as fast as possible.”
immediately call 15 or 112
How do you know if you have broken heart syndrome?
“Once help arrived on the scene, a electrocardiogram is realised. Then, as soon as they arrive at the emergency room, the doctors carry out a coronary angiography, a cardiac examination that allows you to observe the arteries and the heart and to see if the person has had a heart attack with one or more coronary arteries blocked or very narrowed by cholesterol plaque. In the case of a Tako Tsubo, this examination is normal: this is what makes it possible to rule out the path of the infarction” explains the cardiologist. “The product injected into the heart during coronary angiography also allows you to see the shape it has: if the latter is in the form of an amphora, an octopus trap, then it is probably a Tako Tsubo.” At the same time, an ultrasound of the heart and a cardiac MRI are performed and will confirm the diagnosis. “Until we have the Tako Tsubo diagnosis, we treat the patient as if they were having a myocardial infarctionthen when the diagnosis is refined, we stop the coagulants and we only extend the treatment for heart failure.
How to treat broken heart syndrome?
“Following the diagnosis of a Tako Tsubo, we immediately set up the treatment given for heart failure. We can possibly place the person on cardiac support if she is in cardiogenic shock, that is to say if the heart no longer contracts at all on its own” informs Professor Claire Mounier-Véhier, cardiologist. “The treatment lasts until the person recovers a normal contraction of the heart, that is to say between 3 and 6 months.” In addition to this treatment, the person goes into rehabilitation. “It is also important toact on stress management, because it is he who is involved in the broken heart syndrome.” How ? “We can recommend brief therapies, mindfulness meditationthe practice of cardiac coherence or the music therapyact on your sleep, practice daily physical activity, take a nap.”
Does broken heart syndrome leave scars?
“It is completely reversible”
“Tako Tsubo Syndrome occurs very suddenly, it’s scary, but if caught in time, it’s totally reversible : there is no sequelae” inform the cardiologist. That’s the good news!“That’s whyanticipate your stress and alert the emergency services from the first symptoms is important.” However, “broken heart syndrome can recur in 11% of cases at 5 years.” The only risk of sequelae is “related embolic complications of a Tako Tsubo, and is not related to the heart itself. For example, if blood clots form in the heart that no longer contracts during broken heart syndrome, this clot can then travel to the brain and can cause a stroke. There will be sequelae of the stroke, but they will not be sequelae of the heart.”
Can you die of a broken heart?
“Cardiac arrest is the ultimate but rare complication of broken heart syndrome, says Professor Claire Mounier-Véhier. The rate of mortality is 3%, knowing that there are around 1500 cases per year in France, excluding covid-19. With the Covid and the stress that the period generates, this rate has on average been multiplied by three.
Thanks to Pr Claire Mounier-Véhier, cardiologist at the University Hospital of Lille and co-founder of the Association Acting for the Hearts of Women and author of the book “My fight for the hearts of women, Act before it’s too late”. Editions Marabout (2019).