It is called Tako-Tsubo syndrome from the name of a Japanese vessel used in fishing. An international consensus document has now been drawn up on this eventuality
A familiar contrast in a fifty-year-old hospitalized for gastrointestinal problems and suffering from chronic anxiety, he triggers a disproportionate reaction: in short, the man develops a acute emotional stress followed by cardiogenic shock and ventricular fibrillation
which within a few days leads him to death. A case reported by Chinese doctors in the magazine Cardiovascular Innovations and Applicationswhich brings attention to the
Tako-Tsubo syndrome, also called broken heart syndrome or, according to popular view, heartbreak.
The warning signs
It shows up with one state of fatigue associated with shortness of breath and difficulty in chest pain, often followed by loss of consciousness. Symptoms that suggest a heart attack, also because the electrocardiogram often seems to confirm it, and the typical alterations are also detected in the blood. But if a coronary angiography is performed – the direct observation of the coronary arteries, the arteries that supply the heart and that when they close they cause a heart attack – it turns out that are free of obstructions that can justify such striking symptoms. Studies carried out on patients with this syndrome, often not recognized because it is confused with myocardial infarction, show that their heart begins to contract in an altered and uncoordinated way, especially at the tip, so that it can no longer pump blood into the arteries.
Traps of fishermen
It also derives from it a change in the shape of the heart’s left ventricle, which ends up resembling that of a vessel. The name Tako-Tsubo derives precisely from the similarity of the shape assumed by the heart with that of certain ones traps used by Japanese fishermen to catch octopuses, called precisely by this name. Recently been drafted an international consensus document on this syndrome, published in the European Heart Journal, which clearly establishes its clinical characteristics and epidemiological aspects. Today we know that a fairly rare conditionthat it affects women more than menespecially around the age of 65-70, and in any case generally over the age of 50. Upstream of this sudden cardiological storm there seems to be a rapid increase in stimulation of the sympathetic autonomic nervous system, with excess production of
catecholamine
, such as noradrenaline, evidently initiated by emotional stimulation. Since broken heart syndrome occurs only in a very small percentage of cases of emotional shock, evidently in some people there must also be some predisposition that makes them susceptible.
Gender and heredity issue
As for women, a role seems to be played by the reduction in the level of estrogen caused by menopause, but it probably exists. also a genetic predisposition, as shown by some cases in which several members of the same family have experienced this severe syndrome. Some mental disorders also contribute to the predisposition, especially depression and chronic anxiety states. I notice that those who suffer from these ailments tend to have an exaggerated production of norepinephrine in response to emotional stress. But sometimes the syndrome can also occur as a result of sudden physical disturbances, such as after a stroke, a subarachnoid hemorrhage or even a seizure. It can also show up for a combination of physical and psychic stimuli, as happens when the syndrome occurs in those already hospitalized, as in the case of the patient reported by Chinese doctors. In the vast majority of cases for the emotional shock to trigger the storm.
Conflicts and excessive joys
also been compiled a list of the most frequently associated shocks to Tako-Tsubo syndrome: for example theexposure to acute interpersonal conflicts or episodes of personal violencebut also economic meltdowns, job losses, major gambling losses, arrest. Even major catastrophic events can trigger the syndrome in those predisposed, such as earthquakes, floods and collapses. And there is even what is called
cheerful heart syndrome
: A strong positive emotion, such as a big lottery win or even a surprise birthday party, can turn into a storm that overwhelms the heart in the predisposed one.
April 9, 2022 (change April 9, 2022 | 19:46)
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