Death from Broken Hearts and Octopus Traps

It is now established beyond any doubt that women in particular can die of a broken heart. The good news is that if you can make it to hospital, your chances of survival are pretty high.

First described in 2005 in Japan, the Tako-tsubo syndrome (or the “broken heart syndrome”) is being increasingly reported in world literature, although it must have been happening all the time. In 80% of cases, it reportedly occurs in post-menopausal women above 60 years of age after an episode of stress or occasionally related to anger. Death of a close relative is the most common situation.

The word “Tako-tsubo” in Japanese means a octopus trap which is still used by fishermen for catching octopuses, and refers to the abnormal contraction of the left ventricle of the heart after the onset. In this condition, stress leads to a ballooning of the left ventricle, through massive releases of norepinephrine (noradrenaline), stunning the heart muscle, so to speak. There is no involvement of the coronary arteries (supplying the heart) in this disorder, although the condition mimics a “heart attack” when presenting to doctors. The cardiac enzymes are only mildly raised, reflecting the fact that there is little muscle damage, and only severe stunning.

Recent papers suggest that the condition can be triggered by moderate stress, and is particularly common in the US and Europe. Around 95% pull through if the condition is diagnosed promptly, in most of whom heart function returns to normal.

In addition, an inverted form, where the tip of the heart beats normally, but the base of the left ventricle is stunned (inverted Tako-tsubo syndrome) has been more recently described in patients with pheochromocytoma (a norepinephrine secreting tumor), severe brain injury, and other brain disorders. The prognosis is quite good in this condition as well, once diagnosed and placed under cardiac support.

The Tako-tsubo syndrome, representing a stress-linked cardiomyopathy (muscle dysfunction), provides direct evidence how the mind can be linked to our bodies through stress.

Note: Pictures and videos of the Tako-tsubo syndrome and its inverted form can be found at www.takotsubo.com.