A diagnosis of stress-induced cardiomyopathy is also known as takotsubo cardiomyopathy and broken heart syndrome. It means the heart has been weakened by an acute period of emotional or physical stress.
It can bring on heart attack–like symptoms. Stress-induced cardiomyopathy can potentially be a life threatening condition.
Most people who experience stress-induced cardiomyopathy recover with little or no treatment beyond the use of medications to ease the workload of the heart. However, in rare cases, heart failure and other complications can develop, requiring more invasive treatments to support heart function.
When stress-induced cardiomyopathy occurs, the lower part of the left ventricle — the heart’s main pumping chamber — expands. This change in the left ventricle’s shape and size can cause the heart to work harder to pump blood efficiently throughout the body.
Stress-induced cardiomyopathy is usually a reversible condition. Full recovery is likely in most cases.
The reason stress-induced cardiomyopathy is also referred to as “broken heart syndrome” is that it usually occurs soon after a stressful event, such as the loss of a spouse or partner.
According to the National Organization for Rare Disorders, about 90% of the people who develop stress-induced cardiomyopathy are women. About 8 out of 10 of them are ages 50 and older.
Though the condition is often associated with the sudden loss of a spouse, any stressful situation can trigger stress-induced cardiomyopathy.
Often, triggers fall into one of two categories: emotional or physical stress. Some common triggers include:
- asthma attack
- diagnosis of a chronic illness
- financial problems
- neurological events, such as a stroke
Certain drugs, including those that treat severe allergies, nervous system disorders, depression, and thyroid disease, may also be risk factors.
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An acute episode of stress may cause an abnormally high level of stress hormones to flood the body. Normally, these hormones help you get through a stressful situation.
But if too much adrenaline and other chemicals, such as catecholamines, begin circulating, several potentially harmful changes can occur.
The small arteries within the heart can narrow, limiting blood flow to the heart muscle. Hormones may bind to cells in the heart, allowing calcium to accumulate quickly and reducing the efficiency of the heart’s pumping action.
Symptoms of stress-induced cardiomyopathy may begin within a few minutes or hours of a stressful event. They may also appear later on — particularly in relation to emotional triggers — as you process the stressors in your life.
Some of the most common symptoms include:
- chest pain that may come on suddenly and severely
- dizziness or lightheadedness
- a racing heart
- shortness of breath
- sweating for no reason (it may feel like a cold sweat)
Stress-induced cardiomyopathy often resembles acute coronary syndrome (ACS). ACS refers to the sudden reduction in blood flow to the heart muscle. ACS can include a heart attack or angina (chest pain).
To distinguish stress-induced cardiomyopathy from ACS, a healthcare professional may perform several tests and order imaging tests. Among them are:
- blood tests to check for cholesterol, glucose, and certain protein levels that can indicate a heart attack or other heart problem
- chest X-ray
- coronary angiography, which uses cardiac catheterization to measure blood flow through the heart
A doctor will also review your medical history and any other symptoms you may have, including emotional stress and feelings of depression and anxiety.
If there’s a likely physical or emotional trigger, be sure to share that information with the healthcare professional making the diagnosis.
In most cases, stress-induced cardiomyopathy can be reversed with no long-term complications.
However, in some people, the condition can lead to recurring symptoms. In rare cases, serious health problems, such as heart failure, might materialize.
Stress-induced cardiomyopathy used to be seen as a fairly benign condition, but in recent years, healthcare professionals have begun to take it more seriously.
Today, healthcare professionals make it a greater priority to start treatment early and
There’s no formal treatment for stress-induced cardiomyopathy. In most cases, doctors prescribe medications to lighten the burden on the heart and lower blood pressure.
Some commonly prescribed drugs include:
- angiotensin converting enzyme (ACE) inhibitors
- angiotensin II receptor blockers (ARBs)
A brief hospital stay may be needed, especially if symptoms and left ventricular dysfunction are serious.
After discharge, participating in cardiac rehabilitation may be helpful. During cardiac rehab, you learn more about maintaining optimal heart health through:
- lifestyle changes
- regular doctors’ appointments
If an emotional trigger set off stress-induced cardiomyopathy, your doctor may recommend mental health counseling to help you cope with your grief, anxiety, or other challenges.
In many cases, recovery depends on the trigger.
The more effectively and thoroughly you manage the underlying physical cause of stress-induced cardiomyopathy, the better chances you have of experiencing a full recovery.
Similarly, therapy or other means of managing your emotional and psychological health can also improve your recovery odds.
Review authors also noted that about 11% of people diagnosed with the condition and discharged from a hospital have a recurrence of stress-induced cardiomyopathy during the 4 years following hospital discharge.
Because stress-induced cardiomyopathy and a heart attack have similar symptoms, it’s critical that you treat sudden and intense chest pain and related symptoms as a medical emergency.
If you receive a diagnosis of stress-induced cardiomyopathy, talk with your doctor about what to look out for if complications may be developing. You can also make it a priority to manage your physical and mental health to lessen the chances of recurrence.