"Stress" cardiomyopathy: Another type of heart attack

Most heart attacks are caused by the coronary arteries are blocked by blood clots that form when the cholesterol plaque rupture. The lack of blood flow through blocked arteries cause death of heart muscle - hence the name "heart attack".

But in recent years, doctors have come to recognize and understand other form of heart attack. This rare type of heart attack has no plaques or rupture of blood vessels clogged. He called Takotsubo cardiomyopathy or stress cardiomyopathy. 

Japanese doctors, who were the first to describe this condition, she was named "Takotsubo" because during this disorder, the heart takes on a distinctive shape that resembles a Japanese pot used to trap octopus. The disorder is generally believed to be caused by the sudden emotional stress, such as the death of a child, and be much less harmful than the typical heart attack. For this reason, some have also marked this condition "broken heart syndrome."

A study in the September issue of 3 New England Journal of Medicine reports on the work of an international collaboration of US and European doctors who studied 1,750 patients with Takotsubo cardiomyopathy. Interestingly, 90% of these cases were women, and women in this study were on average 67 years. The most common triggers of stress cardiomyopathy were physical (such as lung problems, infections), and the next most common cause was a "shock" emotional. But a substantial proportion of patients, no trigger which could be identified.

Compared to people who had suffered a "typical" of heart attack, patients with Takotsubo cardiomyopathy were almost twice as likely to have a neurological or psychiatric disorder. And contrary to common belief among doctors that Takotsubo cardiomyopathy is less severe than other forms of heart attack, death rates in hospital again Takotsubo attacks 'traditional' cardiomyopathy were similar.

As awareness of this disease increases between doctors and patients, I think we will be even more cases of Takotsubo cardiomyopathy grateful to the future. The condition certainly does not seem as rare as suspected, not as harmless as previously believed. Further research is needed to determine the best care for patients with Takotsubo cardiomyopathy and reduce your risk of future problems.  

At this time, we often use the same drugs to treat heart muscle weakened Takotsubo cardiomyopathy as we do with other forms of heart attack, but really are not many good studies yet on optimal treatment options for people who they have experienced Takotsubo cardiomyopathy.  

The link with neurological or psychiatric disorders is intriguing and suggests that an important mind-heart connection is relevant to certain manifestations of Takotsubo cardiomyopathy, and perhaps also other heart conditions. This article in the New England Journal of Medicine sure to generate more interest in the study of this fascinating disease.
By: Deepak Bhatt, MD, MPH