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Cracked heart syndrome, or stress cardiomyopathy, is a now-recognized heart disease that “mimics” heart attack.
It manifests itself with intense chest pressure, shortness of breath and sudden weakness. The syndrome was identified as a separate entity by Japanese physicians in the early 1990s and was initially known as “takotsubo disease” because of the similarity of the shape of the diseased heart to the Japanese octopus fishing tool.
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How is Cracked Heart Syndrome caused?
The exact pathophysiology of stress heart disease remains unclear and a variety of neurohormonal mechanisms are likely to be involved. The body, to deal with sudden intense situations, produces the so-called stress hormones, catecholamines: adrenaline and noradrenaline.
“In this syndrome the level of catecholamines has been found to be much higher than other serious conditions e.g. myocardial infarction, pulmonary edema, etc. It is not known why in some people under stress the myocardium is suddenly flooded by an excessive amount of catecholamines and in others not. Catecholamines cause the small arteries to constrict, resulting in a sharp but temporary reduction in their perfusion. Also, the adrenaline associated with the heart cells causes a large amount of calcium to enter them, which affects their normal function. It is unknown which of the two mechanisms is more important “, explains Mr. Nikolaos Stratigis, Director Cardiologist at Metropolitan Hospital.
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Frequency of the syndrome
About 1% & # 8211; 2% of cases with acute coronary syndrome actually suffer from cracked heart syndrome. 70% of these cases are middle-aged women. As a rule, this condition is triggered by a sudden sudden stress that is usually mental, such as the death of a loved one, separation, sexual rejection, feelings of betrayal and anger. However, it can also be physical stress, so cardiomyopathy can be followed by a severe asthma or epileptic seizure, a hemorrhagic stroke, laborious and prolonged surgery, etc.
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Similarities and differences with heart attack
As noted above the symptoms are similar to those of a heart attack. Cardiogram and biochemical blood tests do not help to distinguish between these two diseases. The suspicion of the existence of cracked heart syndrome is reinforced by the association with recent intense stress in combination with the findings of the echocardiogram that in typical cases are characteristic: the left ventricle of the heart appears with strong stimulation of the apex and its apex. balances overlap. However, the diagnosis is substantiated by coronary angiography, which proves the patency of the coronary arteries.
In myocardial infarction, the myocardium dies due to cessation of perfusion due to coronary artery occlusion. In contrast, in the case of stress cardiomyopathy, the myocardium suffers from the “toxicity”, in a way, of stress hormones such as adrenaline.
This lesion is usually reversible and resolves within a few days or weeks and the risk of recurrence of the syndrome is generally low.
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Prognosis
“Initially there was an impression that it was an innocent condition due to the absence of coronary heart disease and the fact that in most cases with aggressive supportive treatment the heart function is restored in a few days or weeks. But there is in-hospital mortality that is not much different from acute coronary syndrome and is due to a number of serious complications such as abdominal arrhythmias, systemic thromboembolic events and cardiogenic shock.
The risk is greater when the cause is physical stress such as “Hemorrhagic stroke, epileptic seizures, severe asthma attack, heavy bleeding, hypoglycemia, high fever, etc., where the risks of the underlying disease are added”, concludes Mr. Stratigis.
Source: News247. gr
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