"Broken Heart Syndrome", or takotsubo Cardiomyopathy: Causes, Diagnosis, Symptoms and Treatment

"Broken Heart Syndrome" - an unusual name for pathology. The origin of such a name is due to the etiology of the disease: when a person experiences a strong emotional shock, it, one way or another, affects the work of the heart. But in a number of cases, violations in the functioning of the cardiac system become not just a deviation, but a symptom of the disease. In medical sources one can find another name for pathology - "takotsubo cardiomyopathy".

The essence of the disease

The most common cause of the syndrome is the body's reaction to the death of a loved one. Stress cardiomyopathy is a disease of the cardiovascular system, manifested as discomfort in the chest area after severe stress.

According to statistics, women face this problem more often than men, which is due to the pronounced emotionality of the fair sex. The greatest number of cases was recorded in patients aged 60 to 70 years.

According to the system of coding of somatic pathologies ICD-10, the syndrome of "broken heart" is designated as I42.8.

Etiology

The exact origin of the disease is unknown. One can only assume an approximate mechanism of how the pathology develops.

Initially, there is a kind of psychoemotional stress, which leads to a violation of the balance of the vegetative system. It consists of sympathetic and parasympathetic departments. One of them is responsible for the process of relaxation of the body, the other for its activation.

These two departments never work at the same time. The activity of one is always replaced by the launch of another. If the existing balance is broken, which is known in medical practice as "vegetovascular dystonia", there is a sharp increase in the adrenaline concentration in the blood. This hormone complicates the work of the heart, narrowing the arteries and damaging the tissues of the main muscle of the body.

Symptoms

Symptoms of "broken heart syndrome" are similar to those of a heart attack. So, the patient can experience:

• Sharp pain in the sternum, giving in back or hand;
• Fluctuations in blood pressure;
• Shortness of breath after minor physical exertion or in the absence of it;
• Physical weakness, drowsiness, lack of appetite.

When faced with such symptoms a person takes "Nitroglycerin", the tablet does not have the proper therapeutic effect. The attack can last for a while. However, the deterioration of health, characteristic of these heart attacks, is not observed.

Stages of development

The "broken heart syndrome" proceeds spasmodically. Periods of seizures are followed by a stable remission. A vegetative disorder is the time of the absence of a characteristic symptomatic pathology. Violation of balance in the work of the sympathetic and parasympathetic departments makes the nervous system vulnerable. Under the influence of any provoking factor, in the role of which stress, fatigue or even a cold can act, the "broken heart syndrome" passes into the stage of exacerbation.

Forms of Disorder

The existing classification of the pathological process examines it from the point of view of the localization of injuries inflicted to the cardiac muscle during seizures. The disease can be diffuse or local. What is the difference between these two forms?

Diffuse defeat of the tissues of the heart muscle is less dangerous than the local one. However, it also requires close monitoring by the attending physician. Definition of the specific form of the disease is possible only after carrying out an electrocardiogram. With this variant of the study, a specialist is able to consider any morphological changes in the tissues of the heart muscle.

Medical Examination

Diagnosis of the "broken heart syndrome" is carried out by a certain algorithm, which allows you to differentiate the disease from similar pathologies.

Initially, the doctor is studying the patient's anamnesis. To this end, he can ask a number of clarifying questions: how long did the first symptoms of the disease appear, which stress factors preceded their occurrence, which family member was confirmed with such a diagnosis, etc. It is important to understand that pathology develops exclusively as a reaction to acute emotional experience. To form a disease, it is necessary to have an event that can cause such significant changes in the physiology of the human body.

After that, a diagnostic plan is appointed, which differs little from any other cardiological diseases:

• Blood test for high and low density cholesterol (lipidogram);
• electrocardiogram;
• Echocardiography;
• Computer or magnetic resonance imaging;
• Angiography of vessels;
• X-ray of the heart.

There is no need to go through the entire list of tests. In each individual case, the physician determines the list of laboratory and functional studies separately.

Methods of treatment

The exact causes of the development of takotubo cardiomyopathy are unknown. Therefore, specialists can not offer a universal plan to combat the disease. Doctors usually prescribe a course of therapy, similar in principle to the treatment of hypertension. With its help, you can prevent complications such as a heart attack or stroke.

Medication includes antihypertensive drugs: ACE inhibitors, beta-blockers, calcium channel blockers. The cause of the "broken heart syndrome" is often an emotional shock. Therefore, for therapeutic purposes, it is necessary to use medications that help stabilize the emotional state. You should not select them yourself. First, such drugs must be taken fairly long courses. Secondly, they have a large number of side effects and can provoke addiction.

To stop the symptoms of the "broken heart" syndrome, you can use antidepressants, tranquilizers, vegetative stabilizers. With insignificant manifestations of pathology, it is better to use preparations on a plant basis. Their action is softer. The therapeutic effect will need to wait longer, but the likelihood of side effects is reduced to almost zero.

In order for the body to have enough strength and energy to eliminate the somatic disorder, a person in the rehabilitation period needs to receive adequate nutrition. The question of the assimilation of vitamins in the form of tablets is still open. However, the benefits of minerals from food are enormous.

The diet itself should be made taking into account the presence of cardiovascular pathology. From the menu, you should completely eliminate coffee, strong tea, alcohol, fatty and salty foods. The purpose of this diet is to reduce the risk of atherosclerosis, which complicates the work of the heart muscle.

Treatment of "broken heart syndrome" consists of a set of procedures aimed at alleviating the state of health and preventing life-threatening complications. Self-control of this disease is extremely undesirable. It is better to find a specialist who will monitor the process of therapy and subsequent rehabilitation. For example, residents of the capital with this problem can turn to the Bakulev Cardiology Center.

Methods of prevention

Warn the development of the syndrome is very difficult, because pathology is a physiological response to a strong emotional experience. On the other hand, stress resistance is a property of the human body, which can theoretically be developed.

To do this, you must adhere to the rules of a healthy lifestyle, namely - to engage in physical activity. To this end, an ordinary person should spend at least 300 minutes of his time per week. In this case, do not give the body excessive loads, which have a bad effect on the condition of the tissues of the heart and blood vessels.

Food is also important. The use in large quantities of fatty and high-calorie foods provokes the development of atherosclerosis, which destroys the blood vessels and changes the composition of the blood. Insufficient nutrition provokes hormonal imbalance, which can cause complications from all body systems.

A key role in the successful prevention of any pathology is the regular referral to the doctor for prophylactic medical examinations. A person can independently choose where to go to: a district clinic, the Bakulev Cardiology Center, a private office of a cardiologist. At the same time visiting a specialist is recommended at least once a year, including in the absence of serious health problems or severe symptoms of cardiac dysfunction.

Possible complications

Despite the absence of universal therapeutic measures to combat pathology, it is extremely important, after its detection, to comply with all the prescriptions of the attending physician. Do not give up drug treatment, observe a fairly strict diet. These measures are aimed not only at eliminating the disease, but also in protecting the cardiovascular system from the development of the following complications:

• Chronic heart failure;
• Heart attack;
• arrhythmia;
• Thromboembolism;
• pulmonary edema.

Forecast

In stressful cardiomyopathy, the risk of death is extremely low, but still exists. With timely access to the doctor and the implementation of all of his recommendations, recovery occurs in about 2 months.

Knowing the main causes and initial manifestations of the pathological process, you should not hesitate with his treatment. You should immediately seek qualified medical help. In addition, this information can prevent the development of the disease in the early stages, therefore, avoid the occurrence of possible complications.