Tako-tsubo Cardiomyopathy: What It Is, Symptoms, Causes And Treatment
The heart is one of the most important organs in our body, since it allows the oxygen and nutrients that each and every one of the body’s organs to survive through the cardiovascular system.
However, as with other organs, the heart can be affected by multiple factors. And we are not just talking about pathogens, but even emotional aspects can influence it and even generate events and heart diseases. This is what happens with broken heart syndrome or tako-tsubo cardiomyopathy about which we are going to talk throughout this article.
It is called tako-tsubo cardiomyopathy or transient apical dyskinesia. a type of coronary pathology characterized by the presence of temporary left ventricular dysfunction which happens to have an abnormal heartbeat in the absence of blocked arteries or an injury that explains this behavior.
It is a weakening of the heart muscle, which presents hypokinesia or akinesia in the most apical parts (at the end of the ventricle the muscle loses part or completely its mobility).
The ventricle in question has a peculiar morphology, with a bulge at the bottom or balloon-shaped tip of the ventricle (another name is transient apical ballooning syndrome) which makes it look similar to the traditional Japanese octopus pots that give its name to this disorder (takotsubo).
This temporary alteration is also called broken heart syndrome or stress cardiomyopathy, because a considerable proportion of cases come from experiencing situations of strong stress or emotional pain, such as those caused by the death of a loved one. an unexpected breakup, the diagnosis of a feared illness or the experience of intimate partner violence.
The symptoms are very similar to those of an acute coronary syndrome or a heart attack: chest pain and heart failure, there is also an increase in cardiac biomarkers and alterations in heart rhythm visible in electrocardiogram. The big difference is that in this case the arteries are not blocked, although blood flow may be reduced. It is a pathology that can appear in people of both sexes and at any age, although it is more common among women between fifty and seventy years of age.
Although we are generally faced with a temporary disorder that can normalize on its own and with a very favorable prognosis, the truth is that although it is not common Sometimes complications can occur such as (among others) ventricular fibrillation or cardiogenic shock, heart failure, thrombus formation, mitral regurgitation, arrhythmias or rupture of the ventricle wall.
Main causes and explanatory hypotheses
Although the causes of tako-tsubo cardiomyopathy are not completely known in all cases, requiring further research in this regard, it is Some typical causes of this alteration are known
One of the most validated explanatory theories states that a large part of the cases of this disorder can be explained by the presence of high levels of catecholamines in the blood (something that has been found in more than 70% of cases), at levels that They can be up to 34 times the usual amount. We are mainly talking about adrenaline, a hormone that generates excitement and activation of the sympathetic system and therefore generates the activation of the organism.
In turn, this increase is caused in many cases by the experience of severe stress which can be both emotional (a loss, a scare, unexpected and heartbreaking news…) and physical (which have been found in around 50% of cases, of which around 27% have emotional causes).
Other theories propose the presence of occlusive microvascular spasms as an explanation for this temporary situation, generating a brief ischemia, the presence of an abnormal orientation of the mitral valve that generates an obstruction at the outlet of the ventricle, or the presence of deficiencies in the microvascularization. coronary.
Treatment of this pathology
As we have mentioned before, tako-tsubo cardiomyopathy is a temporary disease that generally ends up resolving on its own without leaving sequelae, with a complete recovery in 95% of cases in about one or two months However, when symptoms appear, it is essential to go urgently to a hospital, given that the symptoms are indistinguishable at first glance from other, much more dangerous coronary disorders.
Regarding treatment, as a general rule the solution would be to keep the subject hydrated and reduce or eliminate, as far as possible, the possible stressors that may have caused the syndrome. It is also possible to administer beta-adrenergic blockers or alpha-adrenergic agonists together with angiotensin-converting enzyme, in order to facilitate blood flow in the acute phase as well as recovery. Likewise, in case of complications, they must be treated differentially depending on the type of anomaly that may occur.
