Stress cardiomyopathy, also referred to as “broken heart syndrome,” takotsubo cardiomyopathy, and apical ballooning syndrome, is a condition in which intense emotional or physical stress can cause rapid and severe heart muscle weakness (cardiomyopathy). This potentially life-threatening condition can occur following a variety of emotional stressors such as grief (e.g. death of a loved one), fear, extreme anger, and surprise. It can also occur following numerous physical stressors to the body such as stroke, seizure, difficulty breathing (such as a flare of asthma or emphysema), or significant bleeding.
While the causes of the conditions are different, symptoms of stress cardiomyopathy are often similar to those of a heart attack:
- Chest pain
- Shortness of breath
- Nausea and vomiting
- Palpitations (the sensation of the heart pounding)
Similar to a heart attack, patients with stress cardiomyopathy can present with low blood pressure, congestive heart failure, and even shock. But unlike a heart attack, which kills heart cells, it is believed that stress cardiomyopathy uses adrenaline and other hormones to temporarily stun heart cells. Fortunately, this stunning gets better very quickly, often within just a few days to a few weeks. So even though a person with stress cardiomyopathy can have severe heart muscle weakness at the time of admission to the hospital, the heart completely recovers within a couple of weeks in most cases and there is no permanent damage.
Prognosis and Recurrence
The long-term prognosis for patients with stress cardiomyopathy appears to be excellent. The heart returns to normal within a few weeks with no permanent damage. Research shows that 5% - 10% of patients experience a recurrence of stress cardiomyopathy, even if subsequent stressful events occur in a patient’s life.