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Broken heart syndrome

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Broken heart syndrome (Takotsubo cardiomyopathy)



Extreme stress


Congestive heart failure combined with EKG changes and bulging at the apex of the heart and high catecholamine levels

Mortality Rate



Supportive, including expanding the aorta, fluids, beta blockers and/or calcium channel blockers

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Takotsubo cardiomyopathy (from the Japanese "tako tsubo" or "octopus pot" from the shape the heart takes), colloquially known as broken heart syndrome is a temporary weakening of the upper muscles of the heart, generally from extreme stress, typical of the death of a loved one, a severe attack of asthma or the sudden onset of a serious illness. 

The onset of the condition is caused by high levels of catecholamines, particularly adrenaline.  This weakens the upper chambers of the heart, but generally has no effect on the lower chambers.  This causes the heart to bulge out at the top, giving it the look from which the condition is named.  It is difficult to distinguish from a myocardial infarction, except that there is no overall heart damage with this condition and the patient's angiogram will usually show no blockages that could explain the heart failure.  An echocardiogram will show that the base of the left ventricle is beating normally or very quickly, while the rest of the ventricle is not beating at all.  

Once diagnosed, the condition is very treatable and very survivable.  The highest risk is during the initial acute stage when the disease may be misdiagnosed.  Although patients will often present with low blood pressure due to the inefficient beating of the heart, treating this symptom will actually make the condition worse.  Ironically, drugs that lower blood pressure (and also block catecholamines) are far more effective, such as beta blockers and calcium channel blockers.  Apart from that, patients should be given fluids and observed carefully.  In some cases, the aorta may require expansion.

Takotsubo cardiomyopathy at Wikipedia

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