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Heart Health

10 October 2018

'Broken heart syndrome' warrants careful monitoring

Broken heart syndrome - also called Takotsubo syndrome - causes symptoms similar to a heart attack, including chest pain and difficulty breathing - and still puts patients at high risk for hospital readmission and in-hospital death.

It's not a heart attack, but so-called "broken heart syndrome" still puts patients at high risk for hospital readmission and in-hospital death, a new study suggests.

Broken heart syndrome - also called Takotsubo syndrome - causes symptoms similar to a heart attack, including chest pain and difficulty breathing.

But while a heart attack is caused by severely blocked arteries, broken heart syndrome is typically brought on by stressful events and involves sudden weakening of the heart muscle.

Although the syndrome is thought to be temporary, the study found subsequent heart problems were not uncommon.

"Takotsubo patients should be given a detailed discharge plan and counseled on potential reasons to revisit their doctor, such as difficulty breathing or swelling of the legs," said the study's co-lead investigator, Dr Nathaniel Smilowitz. He's an assistant professor of medicine at NYU Langone Medical Center in New York City.

"These are very sick patients who need close follow-up," Smilowitz said in a hospital news release.

The researchers analysed data from more than 61 400 people hospitalised with broken heart syndrome. They found that 12% were rehospitalised within 30 days of discharge. Of those, nearly 4% died after readmission.

Among heart attack patients, the rates were 17% and 7%, respectively, according to the study.

"Our findings show that Takotsubo syndrome still presents considerable risk to patients after they're initially discharged from the hospital," said senior investigator Dr Harmony Reynolds, an associate professor of medicine at NYU Langone.

"Even though the heart muscle recovers full function in survivors, there are lasting effects on the body. Physicians should monitor Takotsubo patients carefully," Reynolds said.

The researchers noted that the most common cause of hospital readmission among patients with broken heart syndrome was heart failure. It was diagnosed in 11% of broken heart syndrome patients and in 13% of heart attack patients.

The study also found that compared to heart attack patients, broken heart syndrome patients were younger and more likely to be women.

They also had fewer risk factors for heart disease, such as diabetes and obesity, but were more likely to have other non-cardiac illnesses such as depression, rheumatoid arthritis, or chronic pulmonary disease.

The findings were published online October 2 in the European Heart Journal--Quality of Care and Clinical Outcomes.