Zespół złamanego serca – Etiologia i przyczyny

Zespół złamanego serca
Etiologia i przyczyny

Zespół złamanego serca (kardiomiopatia takotsubo) to przejściowa dysfunkcja lewej komory serca, najczęściej wywołana nagłym wzrostem katecholamin (adrenalina, noradrenalina, dopamina), które prowadzą do uszkodzenia kardiomiocytów i skurczu naczyń wieńcowych. Mechanizmy patofizjologiczne obejmują zwężenie dużych i małych naczyń wieńcowych, nadmierny napływ wapnia do komórek mięśnia sercowego oraz dysfunkcję śródbłonka, szczególnie u kobiet po menopauzie z niedoborem estrogenu. Stan zapalny i stres oksydacyjny również odgrywają istotną rolę. Zespół ten jest wyzwalany przez silne stresory emocjonalne (np. żałoba, rozwód) lub fizyczne (np. infekcje, operacje, hipoglikemia), a także przez niektóre leki i substancje psychoaktywne. Około 90% przypadków dotyczy kobiet, głównie po 50. roku życia, a współistniejące zaburzenia psychiczne i choroby układu oddechowego zwiększają ryzyko. Paradoksalnie, cukrzyca może mieć efekt ochronny poprzez stępienie odpowiedzi autonomicznej.

Zespół złamanego serca (Takotsubo cardiomyopathy) – Etiologia

Zespół złamanego serca, znany również jako kardiomiopatia takotsubo, kardiomiopatia stresowa czy zespół balotującego koniuszka, jest tymczasowym stanem sercowym charakteryzującym się nagłym osłabieniem mięśnia sercowego, szczególnie lewej komory. Dokładna przyczyna tego schorzenia nie została w pełni wyjaśniona, pomimo intensywnych badań w tym kierunku.¹²

Rola hormonów stresu

Najczęściej akceptowana hipoteza sugeruje, że zespół złamanego serca jest wynikiem nagłego wzrostu poziomu hormonów stresu, takich jak adrenalina, noradrenalina i dopamina, co prowadzi do „ogłuszenia” mięśnia sercowego. Te katecholaminy mogą tymczasowo uszkodzić komórki mięśnia sercowego lub zaburzyć funkcję naczyń wieńcowych, co uniemożliwia lewej komorze efektywne kurczenie się.¹²³

Wysoki poziom adrenaliny może powodować zwężanie się tętnic doprowadzających krew do serca, co prowadzi do zmniejszonego przepływu krwi. Adrenalina może również wiązać się z komórkami serca, powodując nadmierny napływ wapnia, co utrudnia prawidłowe bicie serca.¹²

Zaburzenia mikrokrążenia i skurcz naczyń wieńcowych

Tymczasowe zwężenie dużych lub małych tętnic serca może odgrywać istotną rolę w rozwoju zespołu złamanego serca. Badania sugerują, że może dochodzić do skurczu naczyń wieńcowych, co prowadzi do ograniczenia dopływu krwi do mięśnia sercowego, szczególnie w obszarze lewej komory.¹²

W sytuacjach stresowych mniejsze naczynia krwionośne układu sercowo-naczyniowego kurczą się zamiast rozszerzać, co dodatkowo komplikuje przepływ krwi do serca.¹²

Czynniki hormonalne i niedobór estrogenu

Większa częstość występowania zespołu złamanego serca u kobiet po menopauzie sugeruje wpływ czynników hormonalnych. Niedobór estrogenu może prowadzić do dysfunkcji śródbłonka, co wiąże się ze skurczem naczyń wieńcowych – jednym z mechanizmów znanych jako przyczyna kardiomiopatii takotsubo.¹²

Uważa się, że żeński hormon estrogen pomaga chronić serce przed szkodliwymi skutkami adrenaliny. Kiedy kobiety przechodzą menopauzę, poziom estrogenu spada, zwiększając tym samym ryzyko rozwoju tego schorzenia.¹²³

Stan zapalny i stres oksydacyjny

Uważa się, że stan zapalny odgrywa kluczową rolę w rozwoju zespołu złamanego serca.¹ Zwiększony stres oksydacyjny, czyli produkcja szkodliwych wolnych rodników tlenowych, wydaje się być istotną przyczyną objawów zespołu złamanego serca.¹

Czynniki wyzwalające zespół złamanego serca

Stresory emocjonalne

Zespół złamanego serca jest typowo wyzwalany przez niespodziewane, emocjonalnie obciążające wydarzenia. Około dwóch trzecich pacjentów z rozpoznaniem zespołu złamanego serca potrafi wskazać konkretne wydarzenie, które wywołało ten stan.¹ Przykłady emocjonalnych stresorów obejmują:¹²³

Śmierć bliskiej osoby lub żałoba¹
Rozwód lub rozstanie¹
Poważna kłótnia¹
Nieoczekiwana utrata (dom, relacja, pieniądze, ukochane zwierzę)¹²
Otrzymanie złych wiadomości (np. diagnoza choroby nowotworowej)¹²
Intensywny strach¹
Przemoc domowa¹²
Problemy finansowe¹

Stresory fizyczne

Zespół złamanego serca może być również wywołany przez stresory fizyczne. Według niektórych badań fizyczne stresory są najczęstszą przyczyną tego schorzenia.¹² Do fizycznych stresorów należą:¹²

Nagły spadek ciśnienia krwi¹
Poważna choroba lub infekcja¹²
Operacja lub zabieg medyczny¹
Silny ból¹²
Atak astmy¹²
Trudności w oddychaniu (duszność)¹
Napad padaczkowy¹
Udar mózgu¹
Wysoka gorączka¹
Niska zawartość cukru we krwi (hipoglikemia)¹
Duża utrata krwi¹
Klęski żywiołowe, takie jak trzęsienia ziemi¹

Leki i substancje indukujące zespół złamanego serca

W rzadkich przypadkach użycie niektórych leków lub nielegalnych narkotyków może prowadzić do zespołu złamanego serca:¹²³

Kokaina i amfetamina¹²
Epinefryna (EpiPen, EpiPen Jr.)¹
Duloksetyna (Cymbalta)¹
Wenlafaksyna (Effexor XR)¹
Lewotyroksyna (Synthroid, Levoxyl)¹
Nadmierne stosowanie fenylefryny¹

Przypadki bez identyfikowalnego czynnika wyzwalającego

Warto zauważyć, że około jedna trzecia pacjentów z zespołem złamanego serca nie potrafi zidentyfikować żadnego konkretnego stresora, który mógłby wywołać ten stan.¹²³ W takich przypadkach lekarze poszukują innych przyczyn, a badacze sugerują, że mogą istnieć inne czynniki związane z układem endokrynologicznym, naczyniowym i ośrodkowym układem nerwowym.¹²

Czynniki ryzyka zespołu złamanego serca

Czynniki demograficzne

Pewne grupy demograficzne są bardziej narażone na rozwój zespołu złamanego serca:¹²

Płeć: Kobiety są znacznie częściej dotknięte tym schorzeniem niż mężczyźni. Około 90% przypadków występuje u kobiet.¹²
Wiek: Osoby powyżej 50 roku życia, szczególnie kobiety po menopauzie, mają wyższe ryzyko zachorowania.¹²

Współistniejące schorzenia

Niektóre choroby współistniejące mogą zwiększać ryzyko wystąpienia zespołu złamanego serca:¹²

Zaburzenia psychiczne: Osoby cierpiące na zaburzenia lękowe lub depresję mają wyższe ryzyko rozwoju tego schorzenia.¹²³
Astma/POChP: Choroby układu oddechowego mogą być czynnikiem ryzyka.¹
Zaburzenia związane z nadużywaniem substancji: Również zwiększają ryzyko.¹

Interesujące jest, że częstość występowania cukrzycy u pacjentów z kardiomiopatią takotsubo jest niska, co sugeruje, że stępienie odpowiedzi autonomicznej w cukrzycy może mieć działanie ochronne przed rozwojem zespołu złamanego serca – tak zwany „paradoks cukrzycowy”.¹

Nieprawidłowe poziomy hormonów

Badania wykazały, że nieprawidłowe poziomy hormonów tarczycy mogą zwiększyć ryzyko wystąpienia zespołu złamanego serca.¹ Jak wspomniano wcześniej, niski poziom estrogenu u kobiet po menopauzie jest istotnym czynnikiem ryzyka.¹²

Okoliczności specjalne i nowe odkrycia

Zespół szczęśliwego serca

Warto zauważyć, że zespół złamanego serca może być wywołany nie tylko negatywnymi emocjami, ale także intensywnymi pozytywnymi wydarzeniami – tzw. „zespół szczęśliwego serca”. Wyzwalaczami mogą być na przykład niespodziewane przyjęcie lub wygranie na loterii.¹²³

Związki genetyczne

Niektóre badania wykazały związek między zespołem złamanego serca a ekspresją określonych genów, takich jak BAG3 i GRK-5, choć wyniki są niejednoznaczne.¹

Związki neurologiczne i psychiatryczne

Istnieje wyższa częstość występowania zespołu złamanego serca u pacjentów z chorobami neurologicznymi i psychiatrycznymi. To skojarzenie może stanowić pozasercowy związek, który należy wziąć pod uwagę.¹

Wzrost przypadków w czasie pandemii COVID-19

Badania wykazały wzrost przypadków kardiomiopatii stresowej w początkowym okresie pandemii COVID-19. Naukowcy z Cleveland Clinic odnotowali wzrost częstości występowania kardiomiopatii stresowej z 1,5-1,8% przed pandemią do 7,8% w okresie od marca do kwietnia 2020 roku, gdy pandemia nasiliła się w Stanach Zjednoczonych.¹² Samo zakażenie SARS-CoV-2 zostało również powiązane z wywoływaniem tego zespołu.¹

Długotrwałe uszkodzenia serca

Chociaż zespół złamanego serca jest tradycyjnie uważany za stan tymczasowy, nowe badania sugerują, że może powodować bardziej długotrwałe uszkodzenie mięśnia sercowego. Badacze odkryli, że części mięśnia sercowego są zastępowane drobnymi bliznami, które zmniejszają elastyczność serca i uniemożliwiają prawidłowe kurczenie się.¹ U niektórych pacjentów różne aspekty funkcji serca pozostają nieprawidłowe nawet do 4 miesięcy po wystąpieniu zespołu.¹

Perspektywy badawcze

Chociaż nasza wiedza na temat zespołu złamanego serca znacznie się poszerzyła od czasu jego pierwszego opisania w Japonii w latach 90. XX wieku, dokładna patofizjologia tego stanu nadal nie jest w pełni zrozumiana. Trwają intensywne badania mające na celu lepsze zrozumienie przyczyn i czynników ryzyka tego schorzenia.¹²

Potrzebne są dalsze badania, aby zrozumieć złożone przyczyny występowania zespołu złamanego serca i określić, które metody leczenia mogą być stosowane w długoterminowym zarządzaniu tym schorzeniem.¹ Większe zrozumienie mechanizmów leżących u podstaw tego stanu może doprowadzić do opracowania bardziej ukierunkowanych i skutecznych strategii leczenia oraz potencjalnych metod zapobiegania u osób z grup wysokiego ryzyka.¹

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Materiały źródłowe

#1 Pathophysiology of Takotsubo Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK538160/
Transient left ventricular apical ballooning syndrome, takotsubo cardiomyopathy, takotsubo syndrome, broken heart syndrome, or stress-induced cardiomyopathy are interchangeable terms used to define a syndrome characterized by transient left ventricular systolic and diastolic dysfunction, electrocardiographic features, and increased levels of myocardial enzymes, similar to acute myocardial infarction, but in the absence of obstructive epicardial coronary artery disease. […] The exact cause of takotsubo syndrome is unclear. However, evidence suggests that an adrenergic surge may contribute to myocardial toxicity or disrupt the microvasculature, leading to left ventricle dysfunction. […] Although the exact etiology of takotsubo syndrome is fully understood, the most plausible cause responsible for takotsubo syndrome is the sudden release of stress hormones, such as norepinephrine, epinephrine, and dopamine, leading to cardiac stunning.
#1 Broken Heart Syndrome: Symptoms, Causes, Treatments
https://www.webmd.com/heart-disease/broken-heart-syndrome?ecd=soc_fb_171218_cons_ref_brokenheartsyndrome&linkId=100000001612918
Broken heart syndrome is a condition with symptoms that may feel like a heart attack, such as chest pain and shortness of breath. It can happen after you go through a very stressful physical or emotional event, such as a stroke or the death of someone you love. Your doctor may call this stress-induced cardiomyopathy. […] During a stressful event, your body releases stress hormones such as adrenaline. High amounts of adrenaline can cause the arteries that bring blood to your heart to get smaller. This lowers blood flow to your heart. Adrenaline can also bind to heart cells, causing excess calcium to enter, which makes it harder for your heart to beat normally. […] A study published in the New England Journal of Medicine in 2005 noted that many of the people being treated for the condition had recently experienced the death of a loved one. The name broken heart syndrome took off in popular culture.
#1 Broken heart syndrome – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/symptoms-causes/syc-20354617
Broken heart syndrome is a heart condition that’s often brought on by stressful situations and extreme emotions. […] The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might damage the hearts of some people for a short time. […] A temporary squeezing of the large or small arteries of the heart may play a role in the development of broken heart syndrome. […] An intense physical or emotional event often comes before broken heart syndrome. Anything that causes a strong emotional reaction may trigger the condition. […] Rarely, use of certain medicines or illegal drugs may lead to broken heart syndrome.
#1 Broken Heart Syndrome Is Real | Franciscan Health
https://www.franciscanhealth.org/community/blog/broken-heart-syndrome-is-real
What becomes of the broken hearted? We’ll get to the answer in a moment. First, you need to know that „broken heart syndrome,” also known as stress cardiomyopathy, is a very real thing. […] Stress cardiomyopathy is a temporary „stunning” of the heart following a traumatic event, such as the sudden death of a loved one. It’s a temporary — but potentially deadly — heart condition brought on by stressful situations and emotions. […] The condition appears to arise when a surge in stress hormones temporarily „stuns” heart muscle cells. During times of stress, the smaller blood vessels of the cardiovascular system constrict rather than dilate. […] Researchers are still learning about the specific causes of broken heart syndrome. It is believed that sudden emotional stress causes a surge of hormones that, in essence, „stuns” the heart muscle. The left ventricle bulges and causes the heart to stop pumping blood normally. (That bulging left ventricle resembles the shape of the takotsubo pot mentioned earlier). […] There currently is no way to prevent stress-induced cardiomyopathy, other than learning basic stress management skills. Women are more likely than men to experience this condition, especially those over the age of 65.
#1 Pathophysiology of Takotsubo Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK538160/
Although roughly one-fourth of patients have no clear triggers, takotsubo syndrome is typically triggered by an unexpected emotionally or physically stressful event. […] The reason why a specific stressful event triggers this condition is not known, but a similar event may not do so at a different time. […] Estrogen deficiency leads to endothelial dysfunction, which is linked to coronary epicardial and microvascular spasmâthe 2 mechanisms known to cause takotsubo syndrome. […] Inflammation is believed to play a critical role in the development of takotsubo syndrome.
#1
https://www.singhealth.com.sg/patient-care/conditions-treatments/broken-heart-syndrome
In some rare cases, the use of certain drugs or medications might also lead to broken heart syndrome. […] Even though the exact cause of broken heart syndrome is unknown, there are certain risk factors that might increase ones chances of getting it. These include: Those who are above the age of 50, especially post-menopausal women, are at higher risk of getting broken heart syndrome. The exact reason for this is not known, but it is thought that the female hormone oestrogen helps to protect the heart from any harmful effects of adrenaline. When women go through menopause, their oestrogen levels decrease, thus increasing their risk of developing this condition. […] Women are more likely than men to have broken heart syndrome. […] Those with a history of mental health disorders such as anxiety or depression have a higher risk of developing broken heart syndrome.
#1 Broken Heart Syndrome | Takotsubo Syndrome (TTS) – Causes, Symptoms, Diagnosis & Treatment
https://www.medindia.net/health/conditions/broken-heart-syndrome.htm
Increased oxidative stress i.e. the production of damaging free oxygen radicals, appears to be a relevant cause for the symptoms of broken heart syndrome. Estrogen deficiency also appears to be another cause since it reduces the protective effect of estrogen on the heart. […] Nearly 90% of women who experience broken heart syndrome are post-menopausal. Use of drugs such as cocaine and opioids or presence of certain brain disorders, such as epilepsy, migraine, traumatic brain injury, stroke, among others could also possibly contribute to the development of broken heart syndrome. […] A recent research study observed that sometimes happy events could also cause or trigger broken heart syndrome.
#1 Broken Heart Syndrome – Victor Chang Cardiac Research Institute
https://www.victorchang.edu.au/heart-disease/broken-heart-syndrome
Its known as broken heart syndrome, stress cardiomyopathy or takotsubo cardiomyopathy, or similar names. It typically occurs when a person experiences sudden acute stress, extreme emotions or a physical injury that can rapidly weaken the left ventricle, the hearts main pumping chamber. […] Around two-thirds of people diagnosed with broken heart syndrome can pinpoint a trigger episode that caused the condition – with a physical cause being the most common reason according to one US study. Emotional stress such as the loss of a loved one was also reported in around 30 per cent of cases. […] But with one-third unable to recall a trigger, its believed that there may be other factors at play – involving the endocrine, vascular, and central nervous systems.
#1 Takotsubo cardiomyopathy (broken-heart syndrome) – Harvard Health
https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome
Broken-heart syndrome, also known as stress cardiomyopathy or takotsubo syndrome, can occur when a person experiences severe emotional or physical stress. […] The condition is usually the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, a serious accident, or a natural disaster such as an earthquake. That’s why the condition is also called stress-induced cardiomyopathy, or broken-heart syndrome. […] The precise cause of broken heart syndrome isn’t known, but experts think that surging stress hormones (for example, adrenaline) essentially „stun” the heart, triggering changes in heart muscle cells or coronary blood vessels (or both) that prevent the left ventricle from contracting effectively. […] Some causes of broken heart syndrome include: sudden drop in blood pressure, serious illness, surgery, or medical procedure (e.g., cardiac stress test), severe pain, domestic violence, asthma attack, receiving bad news (such as a diagnosis of cancer), car or other accident, unexpected loss, illness, or injury of a close relative, friend, or pet, fierce argument, financial loss, intense fear, public speaking, a surprise party or other sudden surprise.
#1 Broken Heart Syndrome: Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/17857-broken-heart-syndrome
Broken heart syndrome is a short-term condition where some of your heart muscle weakens rapidly. This typically happens after a sudden physical or emotional stressor. […] Researchers can’t pinpoint broken heart syndrome causes, but they believe a stressful event like a divorce, car accident or job loss can cause it. When you react to physical or emotional stress, your body releases stress hormones in your blood. Experts think that these hormones temporarily interfere with your heart’s function. […] A small percentage of people with broken heart syndrome (takotsubo cardiomyopathy) can’t identify any stressors that may have triggered their episode. […] Examples of sudden emotional stressors include grief from the death of a loved one or other large or meaningful loss (relationship, home, money or a beloved pet). […] Examples of sudden physical stressors include severe pain, an exhausting physical event, health issues, including asthma attacks, difficulty breathing, seizure, stroke, high fever, low blood sugar (hypoglycemia), large blood loss or surgery.
#1 What is Broken Heart Syndrome? Symptoms and Treatment
https://yeditepehastaneleri.com/en/health-guide/diseases-treatments/what-broken-heart-syndrome-symptoms-and-treatment
Although intense emotional traumas lead to heartbreak, they can actually have significant physical effects on the heart. Cardiology Specialist Prof.Dr. Ali BUTURAK stated that sudden intense sadness, disappointment and stress can lead to broken heart syndrome. […] Dr. Buturak said that the disease is triggered by sudden psychological traumas such as losing a spouse, lover or first-degree relative or a loved one, heavy emotional situations such as separation after a long-term relationship, divorce or being cheated on, or receiving news that will shake the person deeply. […] He emphasized that the danger of drowning, natural disasters such as earthquakes and some physical traumas can also cause broken heart syndrome. […] As a result of the excessive activity of some regions in the brain after sudden intense sadness, disappointment or stress, there is an increase in the stress hormone levels in the blood to levels that can cause damage to the tissues. These hormones attack the heart muscle and small capillaries of the heart, causing sudden contraction defects in the heart muscle and loss of function in small vessels, disrupting cardiovascular circulation.
#1 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK430798/
Takotsubo cardiomyopathy, also known as Gebrochenes-Herz syndrome, transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, and broken-heart syndrome, is a form of non-ischemic cardiomyopathy. […] The exact etiology of takotsubo cardiomyopathy is not fully understood. Several mechanisms are hypothesized as possible etiologies of takotsubo cardiomyopathy, including sympathetic overdrive with increased catecholamines, coronary spasm, microvascular dysfunction, low estrogen levels, inflammation, or impaired myocardial fatty acid metabolism. Risk factors for the development of takotsubo cardiomyopathy include domestic abuse, death of relatives, natural calamities, accident or major trauma, arguments, financial or gambling loss, diagnosis of an acute medical illness, stimulant drugs such as cocaine, amphetamines, or even positive life events the so-called 'happy heart syndrome.’
#1 Broken Heart Syndrome (Takotsubo Cardiomyopathy) Effects
https://www.verywellhealth.com/broken-heart-syndrome-8347541
Broken heart syndrome, or Takotsubo cardiomyopathy, is a form of heart strain that can develop as a result of severe emotional or physical stress. […] Broken heart syndrome is known as stress-induced or Takotsubo cardiomyopathy because it develops from intense emotional or physical stress. […] The exact mechanisms that cause broken heart syndrome aren’t entirely understood, but catecholamines are believed to play a significant role. […] Although extreme emotional stress can trigger the condition and is most commonly associated with this kind of cardiomyopathy, a study from 2020 reveals that more recent evidence points to physical triggers as the most common cause. […] Examples of physical triggers that have been associated with broken heart syndrome are: trauma, surgery, asthma attacks, or natural disasters (i.e., events that cause a rush of adrenaline). […] Certain medications, such as specific combinations of ACE inhibitors and beta-blockers, some antidepressants and antiarrhythmic drugs, and chemotherapy. […] Emotional stress can contribute to broken heart syndrome.
#1 Takotsubo syndrome: the broken-heart syndrome
https://bjcardio.co.uk/2021/03/takotsubo-syndrome-the-broken-heart-syndrome/
Emotional and physical stressors include one or more of the following: divorce, illness or death of a loved one, job loss, bad financial news, earthquakes and aftershocks, car accidents, strokes, seizures, asthma attacks, phaeochromocytoma, giving birth, cancers, infectious diseases, surgery, and anaesthesia. It has even been triggered by SARS-CoV-2 infection.
#1 Broken Heart Syndrome: Causes, Symptoms, and Treatments | SELF
https://www.self.com/story/understanding-broken-heart-syndrome
Broken heart syndrome is a temporary heart condition that’s often brought on by stressful situations, such as the death of a loved one. […] The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. […] A temporary constriction of the large or small arteries of the heart has been suspected to play a role. […] Broken heart syndrome is often preceded by an intense physical or emotional event. Some potential triggers of broken heart syndrome are: News of an unexpected death of a loved one, A frightening medical diagnosis, Domestic abuse, Losing or even winning a lot of money, Strong arguments, A surprise party, Having to perform publicly, Job loss, Divorce, Physical stressors, such as an asthma attack, a car accident, or major surgery. […] It’s also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include: Epinephrine (EpiPen, EpiPen Jr.), Duloxetine (Cymbalta), Venlafaxine (Effexor XR), Levothyroxine (Synthroid, Levoxyl).
#1 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome): Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1513631-overview
A significant emotional or physical stressor or neurologic injury typically precedes the development of the takotsubo cardiomyopathy. […] Cases of takotsubo cardiomyopathy have been reported in the literature following cocaine, methamphetamine, and excessive phenylephrine use. […] Underlying coronary endothelial dysfunction may also play a role in takotsubo cardiomyopathy, wherein an abnormal tendency toward spasticity in the coronary tree can manifest as angina and as takotsubo cardiomyopathy.
#1 What Is Broken Heart Syndrome? Symptoms, Causes, Diagnosis, Treatment, and Prevention
https://www.everydayhealth.com/heart-health/broken-heart-syndrome/guide/
But did you know such trauma could actually trigger a real cardiac condition known as broken heart syndrome? […] Researchers are still working to uncover exactly what causes broken heart syndrome. According to a research paper published in StatPearls, the most likely explanation is that the sudden release of stress hormones that accompanies intense emotional or physical trauma triggers changes to the cells responsible for the contraction of the heart. […] About one-fourth of all cases have no known trigger, but unexpected stressful events tend to bring on the condition. […] There are several known risk factors for broken heart syndrome including: Female sex. The majority of people who experience broken heart syndrome are female. […] Older age. Broken heart syndrome is more commonly seen in adults over the age of 50.
#1 Broken heart syndrome is mysterious, but real | Heart | UT Southwestern Medical Center
https://utswmed.org/medblog/broken-heart-syndrome/
Broken heart syndrome, or takotsubo cardiomyopathy, is caused by a sudden weakening of the left ventricle of the heart the chamber that pumps blood to all parts of the body. […] The exact cause of broken heart syndrome is not fully understood, but many doctors believe it can be triggered by mental or physical stress. It can be a traumatic event, such as the death of a spouse, or something that causes the patient to worry, such as an upcoming surgery. […] According to the 2018 study, risk factors can include anxiety/depression, diabetes, substance abuse disorders, and asthma/chronic obstructive pulmonary disease (COPD). Because it primarily affects older women, some have hypothesized that the condition may be linked to estrogen levels.
#1 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK430798/
The precise pathophysiologic mechanism underlying takotsubo cardiomyopathy remains elusive. Various hypotheses have been postulated and include elevated levels of circulating plasma catecholamines and their circulating metabolites due to underlying stress, microvascular dysfunction or microcirculatory disorder, inflammation, estrogen deficiency, spasm of the epicardial coronary vessels, and aborted myocardial infarction. […] There is some evidence that the prevalence of diabetes mellitus is low in takotsubo cardiomyopathy patients, suggesting that blunting of autonomic response in diabetes may have a protective effect against the development of Takotsubo cardiomyopathy, the so-called „diabetes paradox.”
#1 Can You Really Die From a Broken Heart?
https://www.unitypoint.org/news-and-articles/can-you-really-die-from-a-broken-heart
Dying of a broken heart may sound like its coming from the pages of a book, but it is possible. […] This is known as broken heart syndrome. It is brought on by stressful circumstances, like the death of a loved one. […] According to the American Heart Association (AHA), broken heart syndrome, or takotsubo cardiomyopathy, is a reaction your heart has to a surge of stress hormones caused by an emotionally stressful event. Broken heart syndrome causes the heart to stop operating normally, resulting in heart failure. […] This syndrome is unique in that it can develop in anyone, even someone who is healthy by all other standards, Dr. Martin says. […] Studies also show abnormal thyroid levels can increase the risk of broken heart syndrome. […] If a patient is diagnosed with broken heart syndrome, symptoms can be treated with medicine to help blood flow, prevent blood clots and help control blood pressure, Dr. Martin says.
#1 Takotsubo syndrome: the broken-heart syndrome
https://bjcardio.co.uk/2021/03/takotsubo-syndrome-the-broken-heart-syndrome/
Takotsubo syndrome (TTS) also known as broken-heart syndrome, Takotsubo cardiomyopathy, and stress-induced cardiomyopathy is a recently discovered acute cardiac disease first described in Japan in 1991. […] The aetiology of TTS is not fully understood, despite intensive research into its possible causes. […] The higher incidence of TTS in postmenopausal women suggests hormonal influences. Reduced oestrogen levels during menopause increase endothelial dysfunction (imbalance between vasoconstricting and vasodilating factors) leading to microvascular coronary artery spasm, one of the pathogenetic mechanisms proposed for TTS. […] A few studies have reported an association between TTS and the expression of some genes, such as BAG3 and GRK-5. However, there are conflicting results. […] There is a higher prevalence of TTS in patients with neurological and psychiatric pathologies. This association could represent an extracardiac association that should be considered.
#1 Broken Heart Syndrome: Symptoms, Causes and Treatments | Conditions | U.S. NewsCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon
https://health.usnews.com/conditions/heart-disease/broken-heart-syndrome
In 2020, when the COVID-19 pandemic first emerged, the number of stress-induced cardiomyopathy events increased, according to a study from the Cleveland Clinic published in JAMA Network Open in 2020. The researchers found a 1.5% to 1.8% incidence of stress-induced cardiomyopathy before the pandemic, and a 7.8% incidence from March to April 2020, when the pandemic ramped up in the U.S.
#1 Research shows broken heart syndrome causes long lasting heart damage – BHF
https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2017/june/research-shows-broken-heart-syndrome-causes-long-lasting-heart-damage
A condition once thought to temporarily cause heart failure in people who experience severe stress might actually cause longer-lasting damage to the heart muscle, according to new research that we’ve funded. […] Takotsubo syndrome, also called broken heart syndrome – because it can be triggered when a person suffers severe emotional stress, such as after bereavement – affects around 3,000 people in the UK each year. […] The researchers also found that parts of the hearts muscle are replaced by fine scars, which reduce the elasticity of the heart and prevent it from contracting properly. […] This study has shown that in some patients who develop Takotsubo syndrome various aspects of heart function remain abnormal for up to 4 months afterwards. Worryingly, these patients hearts appear to show a form of scarring, indicating that full recovery may take much longer, or indeed may not occur, with current care.
#1 Is Broken Heart Syndrome Real? | Mass General Brigham
https://www.massgeneralbrigham.org/en/about/newsroom/articles/is-broken-heart-syndrome-real
Broken heart syndrome may sound like a curse suffered by characters in fairy tales, but its actually a very real and serious condition though fortunately rare. Also known as Takotsubo cardiomyopathy or stress cardiomyopathy, broken heart syndrome causes heart attack symptoms in people experiencing a stressful event. […] The exact cause of Takotsubo is still not well understood, but overall, the stressful emotional or physical event results in release of catecholamines (or adrenaline), which affects the heart muscle cells in a way that leads to the temporary weakening of the heart muscle, says Dr. Sarma. […] More research is being done to understand the causes of broken heart syndrome and how it affects the body.
#1 Takotsubo Cardiomyopathy – Broken Heart Syndrome – BHF
https://www.bhf.org.uk/informationsupport/conditions/takotsubo-cardiomyopathy
Takotsubo syndrome, also known as broken heart syndrome, is a condition where your heart muscle changes shape and suddenly weakens. This usually happens when someone is under severe emotional or physical stress. […] The condition is usually temporary and happens to some people when their body is coping with overwhelming physical or emotional stress. […] No one knows the exact cause of takotsubo syndrome. Our experts suggest that a rush of overwhelming stress hormones, like cortisol and adrenaline put sudden stress on the heart, causing temporary damage. For some people, an event like death, illness, surgery, mental trauma or financial stress can trigger takotsubo. […] As takotsubo syndrome is usually caused by stress or trauma, you might find it helpful to talk to a counsellor or clinical psychologist during and after your recovery. […] More research is needed to understand the complex reasons why takotsubo syndrome happens and which treatments can be used to manage it for the long-term.
#1 Is Broken Heart Syndrome Real? | American Heart Association
https://www.heart.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults/is-broken-heart-syndrome-real
Broken heart syndrome, also called stress-induced cardiomyopathy or takotsubo cardiomyopathy, can strike even if youâre healthy. […] Women are more likely than men to experience sudden, intense chest pain â thought to be a reaction to a surge of stress hormones â that can be caused by an emotionally or physically stressful event. […] In broken heart syndrome, a part of your heart temporarily enlarges and doesnât pump well, while the rest of your heart functions normally or with even more forceful contractions. […] Researchers continue to learn more about the causes, and how to diagnose and treat it. […] The bad news: Broken heart syndrome can lead to severe, short-term heart muscle failure.
#2 Takotsubo cardiomyopathy – Wikipedia
https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy
Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart. It usually appears after a significant stressor, either physical or emotional; when caused by the latter, the condition is sometimes called broken heart syndrome. […] The pathophysiology is not well understood, but a sudden massive surge of catecholamines such as adrenaline and noradrenaline from extreme stress or a tumor secreting these chemicals is thought to play a central role. […] Stress is the main factor in takotsubo cardiomyopathy, with more than 85% of cases set in motion by either a physically or emotionally stressful event that prefaces the start of symptoms. […] Although there have been documented cases of TTS without a triggering stressor, it is widely recognized that TTS is preceded by a stressful or emotional event.
#2 Broken heart syndrome – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/symptoms-causes/syc-20354617
Broken heart syndrome is a heart condition that’s often brought on by stressful situations and extreme emotions. […] The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might damage the hearts of some people for a short time. […] A temporary squeezing of the large or small arteries of the heart may play a role in the development of broken heart syndrome. […] An intense physical or emotional event often comes before broken heart syndrome. Anything that causes a strong emotional reaction may trigger the condition. […] Rarely, use of certain medicines or illegal drugs may lead to broken heart syndrome.
#2 Broken Heart Syndrome: Symptoms, Causes and Treatments | Conditions | U.S. NewsCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon
https://health.usnews.com/conditions/heart-disease/broken-heart-syndrome
Broken heart syndrome occurs when a person experiences extreme and severe emotional or physical trauma, which triggers a surge of catecholamine hormones, including adrenaline, in the body. […] „This adrenaline can actually … directly cause myocardial injury and damage the heart,” Chebrolu says. […] As a result, the heart’s left ventricle balloons and causes the coronary arteries that supply blood to the heart to malfunction. […] Examples of stressful events that may cause stress-induced cardiomyopathy include: grief over the loss of a loved one, intense fear, traumatic events, such as car accidents or natural disasters, like wildfires, bad news, and extreme pain. […] However, this type of cardiomyopathy isnât limited only to those events, other stressors can trigger it. In some cases, thereâs no apparent cause.
#2 Broken Heart Syndrome: Causes, Symptoms, and Treatments | SELF
https://www.self.com/story/understanding-broken-heart-syndrome
Broken heart syndrome is a temporary heart condition that’s often brought on by stressful situations, such as the death of a loved one. […] The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. […] A temporary constriction of the large or small arteries of the heart has been suspected to play a role. […] Broken heart syndrome is often preceded by an intense physical or emotional event. Some potential triggers of broken heart syndrome are: News of an unexpected death of a loved one, A frightening medical diagnosis, Domestic abuse, Losing or even winning a lot of money, Strong arguments, A surprise party, Having to perform publicly, Job loss, Divorce, Physical stressors, such as an asthma attack, a car accident, or major surgery. […] It’s also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include: Epinephrine (EpiPen, EpiPen Jr.), Duloxetine (Cymbalta), Venlafaxine (Effexor XR), Levothyroxine (Synthroid, Levoxyl).
#2 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome): Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1513631-overview
Takotsubo cardiomyopathy, also known as stress cardiomyopathy and „broken heart syndrome,” is a sudden, transient cardiac syndrome that involves dramatic left ventricular apical akinesis and mimics acute coronary syndrome (ACS). […] Although the exact etiology of takotsubo cardiomyopathy remains unknown, the syndrome appears to be triggered by a significant emotional or physical stressor. […] The exact etiology of takotsubo (stress) cardiomyopathy (broken heart syndrome) is still unknown, but several theories have been proposed and are under investigation. These include the following: multivessel coronary artery spasm, impaired cardiac microvascular function, impaired myocardial fatty acid metabolism, acute coronary syndrome (ACS) with reperfusion injury, endogenous catecholamine-induced myocardial stunning and microinfarction, underlying coronary endothelial dysfunction.
#2
https://www.singhealth.com.sg/patient-care/conditions-treatments/broken-heart-syndrome
In some rare cases, the use of certain drugs or medications might also lead to broken heart syndrome. […] Even though the exact cause of broken heart syndrome is unknown, there are certain risk factors that might increase ones chances of getting it. These include: Those who are above the age of 50, especially post-menopausal women, are at higher risk of getting broken heart syndrome. The exact reason for this is not known, but it is thought that the female hormone oestrogen helps to protect the heart from any harmful effects of adrenaline. When women go through menopause, their oestrogen levels decrease, thus increasing their risk of developing this condition. […] Women are more likely than men to have broken heart syndrome. […] Those with a history of mental health disorders such as anxiety or depression have a higher risk of developing broken heart syndrome.
#2 Ask an expert: What is broken-heart syndrome? | University of Iowa Health Care
https://uihc.org/health-topics/ask-expert-what-broken-heart-syndrome
For some people, a traumatic event or memory can trigger the physical symptoms of broken-heart syndrome. […] Severe physical and emotional stressorsthe death of a loved one, a catastrophic event, financial loss, a serious medical condition, a car accident, or an emotional memory or anniversaryhave been well known to cause transient heart stunning. […] It appears primarily to affect women, especially women who are over age 55. Researchers believe that postmenopausal women are more vulnerable because of lower levels of estrogens.
#2 Broken Heart Syndrome: Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/17857-broken-heart-syndrome
Broken heart syndrome is a short-term condition where some of your heart muscle weakens rapidly. This typically happens after a sudden physical or emotional stressor. […] Researchers can’t pinpoint broken heart syndrome causes, but they believe a stressful event like a divorce, car accident or job loss can cause it. When you react to physical or emotional stress, your body releases stress hormones in your blood. Experts think that these hormones temporarily interfere with your heart’s function. […] A small percentage of people with broken heart syndrome (takotsubo cardiomyopathy) can’t identify any stressors that may have triggered their episode. […] Examples of sudden emotional stressors include grief from the death of a loved one or other large or meaningful loss (relationship, home, money or a beloved pet). […] Examples of sudden physical stressors include severe pain, an exhausting physical event, health issues, including asthma attacks, difficulty breathing, seizure, stroke, high fever, low blood sugar (hypoglycemia), large blood loss or surgery.
#2 What is Broken Heart Syndrome? Symptoms and Treatment
https://yeditepehastaneleri.com/en/health-guide/diseases-treatments/what-broken-heart-syndrome-symptoms-and-treatment
The triggering factor is often the loss of a loved one (spouse, lover or the news of the death of a first-degree relative), heavy emotional situations such as separation (divorce) or cheating after a long-term relationship, or receiving news that will shake the person deeply (learning that he/she has cancer, etc.). There may be sudden psychological traumas such as In addition, negative experiences experienced by the person (danger of drowning, earthquake damage, etc.) and some physical traumas can also cause broken heart syndrome.
#2 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK430798/
Takotsubo cardiomyopathy, also known as Gebrochenes-Herz syndrome, transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, and broken-heart syndrome, is a form of non-ischemic cardiomyopathy. […] The exact etiology of takotsubo cardiomyopathy is not fully understood. Several mechanisms are hypothesized as possible etiologies of takotsubo cardiomyopathy, including sympathetic overdrive with increased catecholamines, coronary spasm, microvascular dysfunction, low estrogen levels, inflammation, or impaired myocardial fatty acid metabolism. Risk factors for the development of takotsubo cardiomyopathy include domestic abuse, death of relatives, natural calamities, accident or major trauma, arguments, financial or gambling loss, diagnosis of an acute medical illness, stimulant drugs such as cocaine, amphetamines, or even positive life events the so-called 'happy heart syndrome.’
#2 New clues about
https://www.health.harvard.edu/heart-health/new-clues-about-broken-heart-syndrome
As the name suggests, „broken heart” syndrome can arise in response to grief and other intense emotions. […] However, this often reversible but potentially serious condition is more commonly precipitated by physical stress caused by severe illness or surgery. […] Over the years, the recording of physical triggers for takotsubo syndrome rose from 39% to 58% of cases. They included serious medical conditions such as stroke, surgery, infection, cancer, and injuries. […] About one-third of all cases were attributed to emotional triggers, most of which stemmed from either grief or loss, anger or frustration, or interpersonal conflicts. […] All of these triggers activate the body’s fight-or-flight response, prompting an outpouring of stress hormones such as adrenaline. […] This surge of hormones stuns the heart’s microscopic vessels, limiting blood flow to part of the heart. […] Most people fully recover within weeks to months. But the registry data suggest that those who also have other serious health conditions face a higher risk of dying within two months after a takotsubo syndrome diagnosis.
#2 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome): Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/1513631-overview
A significant emotional or physical stressor or neurologic injury typically precedes the development of the takotsubo cardiomyopathy. […] Cases of takotsubo cardiomyopathy have been reported in the literature following cocaine, methamphetamine, and excessive phenylephrine use. […] Underlying coronary endothelial dysfunction may also play a role in takotsubo cardiomyopathy, wherein an abnormal tendency toward spasticity in the coronary tree can manifest as angina and as takotsubo cardiomyopathy.
#2 Understanding Broken Heart Syndrome: Causes, Symptoms, Treatment | CVG Cares – CVG
https://cvgcares.com/conditions/broken-heart-syndrome/
Broken heart syndrome is brought on by physical or emotional stress. Physical stressors that may cause this condition include severe pain, exhausting physical activity, and a variety of health issues such as asthma attacks, difficulty breathing (dyspnea), seizure, stroke, high fever, low blood sugar, intense blood loss, or surgery. […] Emotional stressors that may cause broken heart syndrome include intense good news (surprise party or winning the lottery), intense bad news, grief from the death of a loved one or other meaningful loss (divorce, loss of home, loss of job, loss of money, loss of pet, etc.), intense fear, and extreme anger. […] This condition is thought to be brought on by a sudden surge of stress hormones such as adrenaline, epinephrine, noradrenaline, and norepinephrine, which might temporarily cause a decrease in heart health. These hormones interfere with your hearts ability to function properly and candisrupt your hearts normal rhythm, temporarily enlarge part of your heart (the lower portion of the left ventricle), and creating more forceful contractions in other areas of your heart. These changes lead to temporary heart failure. […] In rare cases, use of certain drugs may lead to the development of broken heart syndrome, such as emergency medications used to treat severe allergic reactions or asthma attacks, anxiety medications, nasal decongestants, or illegal stimulants such as methamphetamine or cocaine.
#2 Broken Heart Syndrome: Causes and Symptoms | AdventHealth
https://www.adventhealth.com/blog/broken-heart-syndrome-causes-and-symptoms
Broken heart syndrome is often triggered by stressful situations, extreme emotions, surgery or a serious physical injury. The stress is usually sudden and acute, emotional or physical, and quickly weakens the heart muscle from the overwhelming amount of adrenaline produced in response. […] The majority of people who develop this condition experienced a stressful event, but about 30% of patients cant trace an identifiable trigger when their symptoms began.
#2 Broken Heart Syndrome: Can you really die of a broken heart?
https://www.baystatehealth.org/articles/broken-heart
While commonly referred to as broken heart syndrome, this condition actually goes by many other names including Takotsubo cardiomyopathy, stress-induced cardiomyopathy, and atrial ballooning syndrome. […] What we do know is that while it has the same symptoms of a heart attack acute chest pain, shortness of breath, arm pain, and jaw pain the cause is not a blockage or cardiovascular disease but rather a dysfunction of the heart muscle; specifically a weakening of the muscle. […] We have yet to determine exactly what causes the weakening but the most popular hypothesis is that there is an adrenal surge. […] Adrenal surges, or rushes of adrenaline, are often brought on by situations that are unusually physical or emotionally stressful. […] However, not all patients who experience broken heart syndrome can identify an event or stressor. In those cases, doctors look for other causes. While it is rare, there are case reports linking some medications, unprescribed stimulants, and underlying endocrine disorders with the condition.
#2 Takotsubo Cardiomyopathy
https://www.svhhearthealth.com.au/conditions/takotsubo-cardiomyopathy
Takotsubo cardiomyopathy or „Broken Heart Syndrome” is when the heart muscle becomes suddenly stunned or weakened. It mostly occurs following severe emotional or physical stress. […] Takotsubo cardiomyopathy is brought on by an extremely stressful physical or emotional event. Common triggers can include the death of a loved one, a serious accident, a fierce argument, an unexpected loss or a sudden illness. These triggers are the reason for the conditions nickname, broken heart syndrome. […] Takotsubo cardiomyopathy can occur at any age in both men and women, but it mostly affects older women.
#2 Can You Really Die From a Broken Heart?
https://www.unitypoint.org/news-and-articles/can-you-really-die-from-a-broken-heart
Dying of a broken heart may sound like its coming from the pages of a book, but it is possible. […] This is known as broken heart syndrome. It is brought on by stressful circumstances, like the death of a loved one. […] According to the American Heart Association (AHA), broken heart syndrome, or takotsubo cardiomyopathy, is a reaction your heart has to a surge of stress hormones caused by an emotionally stressful event. Broken heart syndrome causes the heart to stop operating normally, resulting in heart failure. […] This syndrome is unique in that it can develop in anyone, even someone who is healthy by all other standards, Dr. Martin says. […] Studies also show abnormal thyroid levels can increase the risk of broken heart syndrome. […] If a patient is diagnosed with broken heart syndrome, symptoms can be treated with medicine to help blood flow, prevent blood clots and help control blood pressure, Dr. Martin says.
#2 What is Broken Heart Syndrome? | Brown University Health
https://www.brownhealth.org/be-well/what-broken-heart-syndrome
Broken Heart Syndrome is a real condition. Doctors call it stress-induced cardiomyopathy, or Takotsubo syndrome, because the shape of the heart during the attack resembles an octopus trap (in Japanese: Takotsubo). The Japanese were the first to identify this syndrome in the early 1990s. […] It is important to note that over 90 percent of cases occur in women after menopause and 10 percent in men. It is also very rare in younger women. The reasons are not clear but could be due to differences in hormone levels. […] An interesting feature is that one-third of those experiencing this condition report a significant emotional stressor before the attack (hence the name Broken Heart Syndrome). The stressors may include the unexpected death of a spouse or child, being in an accident, house fires, losing significant amounts of money, public speaking or quarreling. Another third, instead, have physical stressors such as a severe asthma attack, a serious infection, non-cardiac surgery and strokes. And about one-third of people appear to develop Takotsubo without any stressors at all.
#2 Broken heart syndrome is mysterious, but real | Heart | UT Southwestern Medical Center
https://utswmed.org/medblog/broken-heart-syndrome/
Broken heart syndrome, or takotsubo cardiomyopathy, is caused by a sudden weakening of the left ventricle of the heart the chamber that pumps blood to all parts of the body. […] The exact cause of broken heart syndrome is not fully understood, but many doctors believe it can be triggered by mental or physical stress. It can be a traumatic event, such as the death of a spouse, or something that causes the patient to worry, such as an upcoming surgery. […] According to the 2018 study, risk factors can include anxiety/depression, diabetes, substance abuse disorders, and asthma/chronic obstructive pulmonary disease (COPD). Because it primarily affects older women, some have hypothesized that the condition may be linked to estrogen levels.
#2 What Is Broken Heart Syndrome? Symptoms, Causes, Diagnosis, Treatment, and Prevention
https://www.everydayhealth.com/heart-health/broken-heart-syndrome/guide/
Mental health conditions. Individuals living with anxiety or depression have a higher risk of broken heart syndrome. […] Since stress is a major trigger of broken heart syndrome, conditions associated with stress, including depression and anxiety, come with a higher risk. […] Researchers are still working to better understand the causes and risk factors for broken heart syndrome, but its clear acute emotional or physical stress plays a role.
#2 Broken Heart Syndrome (Takotsubo Cardiomyopathy) Effects
https://www.verywellhealth.com/broken-heart-syndrome-8347541
Broken heart syndrome, or Takotsubo cardiomyopathy, is a form of heart strain that can develop as a result of severe emotional or physical stress. […] Broken heart syndrome is known as stress-induced or Takotsubo cardiomyopathy because it develops from intense emotional or physical stress. […] The exact mechanisms that cause broken heart syndrome aren’t entirely understood, but catecholamines are believed to play a significant role. […] Although extreme emotional stress can trigger the condition and is most commonly associated with this kind of cardiomyopathy, a study from 2020 reveals that more recent evidence points to physical triggers as the most common cause. […] Examples of physical triggers that have been associated with broken heart syndrome are: trauma, surgery, asthma attacks, or natural disasters (i.e., events that cause a rush of adrenaline). […] Certain medications, such as specific combinations of ACE inhibitors and beta-blockers, some antidepressants and antiarrhythmic drugs, and chemotherapy. […] Emotional stress can contribute to broken heart syndrome.
#2 Broken Heart Syndrome | Takotsubo Syndrome (TTS) – Causes, Symptoms, Diagnosis & Treatment
https://www.medindia.net/health/conditions/broken-heart-syndrome.htm
Increased oxidative stress i.e. the production of damaging free oxygen radicals, appears to be a relevant cause for the symptoms of broken heart syndrome. Estrogen deficiency also appears to be another cause since it reduces the protective effect of estrogen on the heart. […] Nearly 90% of women who experience broken heart syndrome are post-menopausal. Use of drugs such as cocaine and opioids or presence of certain brain disorders, such as epilepsy, migraine, traumatic brain injury, stroke, among others could also possibly contribute to the development of broken heart syndrome. […] A recent research study observed that sometimes happy events could also cause or trigger broken heart syndrome.
#2 Broken Heart Syndrome: When Sudden Loss or Stress Breaks Your Heart
https://kaplanclinic.com/broken-heart-syndrome-sudden-loss-stress-literally-breaks-heart/
What causes broken heart syndrome? […] Stress-induced cardiomyopathy (SICM), also known as takotsubo cardiomyopathy and/or Broken Heart Syndrome, is a real cardiac condition triggered by extreme stress or anxiety from a traumatic event. […] Along with the loss of a loved one, other emotional or physical stressors like natural disasters, car accidents, sudden financial loss or gain (think lottery!), domestic violence, or even a sudden shock, could all provoke an attack. […] A study published in JAMA Network Open confirmed that pandemic-related stress has caused an increase in stress-induced cardiomyopathy. […] Dr. Reynolds research also aims at explaining why as much as 90% of patients diagnosed with SICM are post-menopausal women. […] Some suspect that the reason for this may be the loss of estrogen during menopause (estrogen is cardio-protective in that it improves blood flow to the heart; as levels drop ones risk for a cardiac event increases).
#2 Broken heart syndrome: causes and outlook | gesund.bund.de
https://gesund.bund.de/en/broken-heart-syndrome
In broken heart syndrome, the functioning of the heart muscle is suddenly disrupted. […] The syndrome can be caused by emotional anguish or stress. […] The syndrome is often triggered by emotional anguish and physical or psychological stress. […] Researchers suspect that, in most cases, an emotionally distressing life event is responsible for triggering the condition. Such events include the loss of a loved one, a separation, or a traumatic event. […] It is suspected that broken heart syndrome is most commonly triggered by a stressful life event. […] There are also some indications that certain therapies and, in rare cases, certain pre-existing conditions can also trigger broken heart syndrome. […] More research is needed to determine exactly why these factors cause a malfunction of the left ventricle of the heart.
#3 Broken Heart Syndrome: Symptoms, Causes, Treatments
https://www.webmd.com/heart-disease/broken-heart-syndrome?ecd=soc_fb_171218_cons_ref_brokenheartsyndrome&linkId=100000001612918
Broken heart syndrome is a condition with symptoms that may feel like a heart attack, such as chest pain and shortness of breath. It can happen after you go through a very stressful physical or emotional event, such as a stroke or the death of someone you love. Your doctor may call this stress-induced cardiomyopathy. […] During a stressful event, your body releases stress hormones such as adrenaline. High amounts of adrenaline can cause the arteries that bring blood to your heart to get smaller. This lowers blood flow to your heart. Adrenaline can also bind to heart cells, causing excess calcium to enter, which makes it harder for your heart to beat normally. […] A study published in the New England Journal of Medicine in 2005 noted that many of the people being treated for the condition had recently experienced the death of a loved one. The name broken heart syndrome took off in popular culture.
#3 Broken Heart Syndrome (Takotsubo Cardiomyopathy) Effects
https://www.verywellhealth.com/broken-heart-syndrome-8347541
Broken heart syndrome, or Takotsubo cardiomyopathy, is a form of heart strain that can develop as a result of severe emotional or physical stress. […] Broken heart syndrome is known as stress-induced or Takotsubo cardiomyopathy because it develops from intense emotional or physical stress. […] The exact mechanisms that cause broken heart syndrome aren’t entirely understood, but catecholamines are believed to play a significant role. […] Although extreme emotional stress can trigger the condition and is most commonly associated with this kind of cardiomyopathy, a study from 2020 reveals that more recent evidence points to physical triggers as the most common cause. […] Examples of physical triggers that have been associated with broken heart syndrome are: trauma, surgery, asthma attacks, or natural disasters (i.e., events that cause a rush of adrenaline). […] Certain medications, such as specific combinations of ACE inhibitors and beta-blockers, some antidepressants and antiarrhythmic drugs, and chemotherapy. […] Emotional stress can contribute to broken heart syndrome.
#3 Broken Heart Syndrome: Causes, Symptoms, and Treatments | SELF
https://www.self.com/story/understanding-broken-heart-syndrome
Broken heart syndrome is a temporary heart condition that’s often brought on by stressful situations, such as the death of a loved one. […] The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. […] A temporary constriction of the large or small arteries of the heart has been suspected to play a role. […] Broken heart syndrome is often preceded by an intense physical or emotional event. Some potential triggers of broken heart syndrome are: News of an unexpected death of a loved one, A frightening medical diagnosis, Domestic abuse, Losing or even winning a lot of money, Strong arguments, A surprise party, Having to perform publicly, Job loss, Divorce, Physical stressors, such as an asthma attack, a car accident, or major surgery. […] It’s also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include: Epinephrine (EpiPen, EpiPen Jr.), Duloxetine (Cymbalta), Venlafaxine (Effexor XR), Levothyroxine (Synthroid, Levoxyl).
#3 Broken Heart Syndrome (Takotsubo Cardiomyopathy) | Clinical Heart and Vascular Center | Condition | UT Southwestern Medical Center
https://utswmed.org/conditions-treatments/broken-heart-syndrome-takotsubo-cardiomyopathy/
Broken heart syndrome, also known as takotsubo cardiomyopathy or stress cardiomyopathy, is a sudden weakening of the hearts pumping function. […] The exact cause of broken heart syndrome isnt fully understood, but many believe it can be triggered by emotional or physical stress, which leads to release of stress hormones. […] The stressor might be a traumatic event, such as the death of a loved one, or something that causes the patient to worry, such as an upcoming surgery. […] However, in many cases, a specific trigger is never identified.
#3
https://www.singhealth.com.sg/patient-care/conditions-treatments/broken-heart-syndrome
In some rare cases, the use of certain drugs or medications might also lead to broken heart syndrome. […] Even though the exact cause of broken heart syndrome is unknown, there are certain risk factors that might increase ones chances of getting it. These include: Those who are above the age of 50, especially post-menopausal women, are at higher risk of getting broken heart syndrome. The exact reason for this is not known, but it is thought that the female hormone oestrogen helps to protect the heart from any harmful effects of adrenaline. When women go through menopause, their oestrogen levels decrease, thus increasing their risk of developing this condition. […] Women are more likely than men to have broken heart syndrome. […] Those with a history of mental health disorders such as anxiety or depression have a higher risk of developing broken heart syndrome.