In Shakespeare’s classic love story, “Romeo and Juliet,” Romeo blames himself for Juliet’s death, believing, albeit mistakenly, that she died of a broken heart.
Alas, poor Romeo wasn’t completely wrong.
First described by Japanese physician Hikaru Sato in 1991, “broken heart syndrome,” also known as stress-induced cardiomyopathy or Takotsubo cardiomyopathy, is a temporary condition that resembles a heart attack but rarely leads to death.
According to Harvard Medical School, more than 90 percent of reported cases of “broken heart syndrome” occur in women ages 58 to 75, and most recover rapidly with no long-term heart damage. Common symptoms include chest pain and shortness of breath.
Patients diagnosed with “broken heart syndrome” who undergo diagnostic exams of the heart are found to have an enlarged left ventricle in the shape of a ceramic pot with a round bottom and a narrow neck. In Japan, fishermen trap octopus in a similar pot called “takotsubo.”
Andre Macedo Dias, MD, a cardiologist with Baptist Heart Specialists, has authored numerous research publications on “broken heart syndrome,” and is involved in several national and international studies on the topic, including one currently under review by the International Journal of Cardiology.
“The number of patients being diagnosed with Takotsubo in the last 10 years has increased dramatically,” he said. “It is commonly triggered by an extremely stressful event where an excess of stress hormones can affect the heart and temporarily weaken it. Medications to improve the strength of the heart muscle, such as beta blockers and ACE inhibitors, are commonly prescribed to treat this reversible condition.”
Underlying anxiety and depression
Dr. Dias first came across a patient exhibiting symptoms of Takotsubo while serving a residency in internal medicine at Danbury Hospital in Connecticut.
“We had a very sick patient in the intensive care unit and while we were discussing end-of-life pathways with his family members, the patient’s daughter became very upset and developed sudden-onset chest pains and had to be taken to the emergency room,” he recalled.
“A diagnostic test of her heart showed it was functioning at only 20 percent capacity. A couple of months later, I saw the same patient for a follow-up and her heart had completely recovered without any surgery. That’s when I decided to find out more about what triggers this syndrome.”
Dr. Dias did more than just research the condition. He helped create one of the largest patient registries for “broken heart syndrome” in the U.S., and his research has been cited in an international consensus document on Takotsubo syndrome that was recently published in the European Heart Journal.
Much like he did in Connecticut and at the Albert Einstein Medical Center in Philadelphia, Dr. Dias plans to create a local registry of patients diagnosed with “broken heart syndrome” and hopes to enroll some of them in a prospective clinical trial through the Baptist Research Institute.
“Many of these patients have underlying anxiety and depression so after they leave the hospital, I want them to be admitted to a specialized unit at Baptist Heart Hospital where they will receive both cardiac rehabilitation and behavioral therapy to cope with anxiety or depression,” said Dr. Dias.
“Several primary care physicians have told me that they have had cases like this in the past but didn’t always know who to refer them to. I believe “broken heart syndrome” isn’t something new. It’s always been out there. And I think Baptist Heart Hospital can be a referral center for this stress-induced cardiomyopathy condition.”
Baptist Heart Specialists provides specialized medical care for patients with a wide range of cardiovascular conditions, including Takotsubo syndrome. To request an appointment with a cardiologist, call 904.720.0799 or visit baptistjax.com/heart.