After the first attack of severe chest pain, the 61-year old woman spent the night in the hospital’s Emergency Department hooked up to a heart monitor, felt better after a few hours, and was discharged in the morning. Even though she had no cardiac risk factors, her blood tests showed that her cardiac enzymes were somewhat elevated, she described a “too-much-adrenaline” feeling, and she had also failed a cardiac treadmill stress test because of heart rate arrythmias. No positive diagnosis was made at the time, although a condition called myocarditis was suggested.
Then nine uneventful years later, a second attack occurred, this one during a very traumatic period in her life, in hospital for a colon resection operation due to cancer. She describes it like this:
“This second attack happened just five days after I underwent my cancer surgery and was still in hospital. It felt to me like a repeat of the first ‘fake heart attack’, and I argued with my internist to this effect.
“At some time on the second day, the T-wave on my EKG had become inverted, and subsequently this became more so. My cardiac enzymes (CK and troponin) were up.
“An echocardiogram two days after the event was reported as a recent LV infarct, and angiogram on the third day showed anteroapical hypokinesis. So I gave in and finally accepted the diagnosis of Takotsubo cardiomyopathy!”
Takotsubo cardiomyopathy (or stress-induced cardiomyopathy or broken heart syndrome is a heart condition traditionally thought to be brought on by extremely stressful situations. This condition mimics a heart attack. It has long been considered by physicians as temporary and reversible, brought on by extremely stressful situations ranging from the death of a loved one to a severe asthma attack, a car accident or even major surgery.
But recent research reported in the New England Journal of Medicine suggests this cardiac event can follow physical exertion as well, but the condition has also been reported with no evident trigger at all. The study in fact described Taktsubo as “an acute heart failure syndrome with substantial morbidity and mortality”, adding: “Patients with Takotsubo cardiomyopathy had a higher prevalence of neurologic or psychiatric disorders than did those with an acute coronary syndrome.”
This cardiac event happens far more often in women, and is NOT a heart attack.(1) Heart attacks are generally caused by a complete or near complete blockage of a coronary artery due to a blood clot forming at the site of narrowing from fatty plaque buildup in the wall of the artery. But in broken heart syndrome, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.
Learn more about this condition here from Harvard University.