Study tracking broken hearts

Last updated: Friday, May 11, 2007 Print

A team of US researchers has created the largest national registry of patients with Takotsubo cardiomyopathy, or "broken heart syndrome."

Researchers at Brown University in Providence, R.I., say the registry will help doctors more easily recognize and treat this rare, life-threatening condition.

Takotsubo cardiomyopathy is commonly called broken heart syndrome, because it is often preceded by some form of emotional or physical distress. The actual cause of the condition, which almost always strikes women, is unknown.

No sign of blockage
Patients are usually critically ill during the first 48 hours, and it often appears that they're having a heart attack. However, there is no sign of coronary artery blockage.

"These patients can be difficult to manage for emergency physicians and cardiologists alike. They may be in cardiac arrest, cardiogenic shock, or severe heart failure. They may require advanced life support with airway management and mediations to support blood pressure," cardiology fellow Dr Richard Regnante said in a prepared statement.

The registry developed by Regnante and his colleagues currently includes 40 patients diagnosed with Takotsubo cardiomyopathy at two major Rhode Island hospitals over a span of 2 1/2 years. Of those patients, 95 percent were women, and 60 percent experienced a stressful event - ranging from armed robbery to a major argument, tooth extraction, or preparation for colonoscopy - before they went to a hospital emergency room for treatment of broken heart syndrome.

The most common symptom among the patients was chest pain (70 percent), followed by shortness of breath (33 percent). All patients showed electrocardiographic (ECG) changes suggestive of an acute coronary syndrome, a term that encompasses both heart attack and unstable angina.

Test shows heart damage
The registry data also shows that a blood test for heart damage was positive in 95 percent of the patients. Cardiac catheterization detected heart motion abnormalities in all the patients. One patient died of acute heart failure.

Most patients who survived the first 48 hours experienced steady recovery and heart function was found to be normal in 29 of the 30 patients who had follow-up echocardiography within a few weeks.

"We don't know why some women develop this syndrome after what appears to be minimal stress, while other women experience severely stressful events but don't develop Takotsubo cardiomyopathy," Regnante said.

It's likely that a surge of stress hormones is a factor. It's also possible that a blood clot temporarily blocks a major artery but then dissolves before it can be detected by doctors, he said.

Data from the registry was expected to be presented at a meeting of the Society for Cardiovascular Angiography and Interventions, May 9-12, in Orlando, Florida. – (HealthDayNews)