Broken Heart Syndrome
Cardiovascular Case Study
Broken heart syndrome, otherwise called stress or Takotsubo cardiomyopathy (TTC), represents an adverse physiological response to an acute psychological or physical stressor (Derrick, 2009). The death of a loved one or experiencing a physically traumatic event, represent two examples of life stressors that can cause this reversible form of cardiomyopathy. Although effective treatment is available, the seriousness of the condition is such that it explains how a person can literally die of a broken heart.
TTC Demographics
An estimated 1.2 million people suffered from an myocardial infarction (MI) in 2007 and approximately 1% (Derrick, 2009, p. 50) to 2% (Wittstein, 2012, p. 2) of MI events was probably due to TTC. Women are far more susceptible to TTC than men and represent approximately 89% of all cases (Derrick, 2009, p. 50). This gender bias shifts the estimated prevalence of TTC among female MI patients to between 4.7 and 7.5% (Wittstein, 2012, p. 2). Based on 2008 estimates of MI for women in the U.S. (American Heart Association, 2011), an estimated 24,000 to 40,000 women suffer from TTC each year.
TTC Signs and Symptoms
Patients often present with signs and symptoms indistinguishable from MI, including chest pain, dyspnea, ECG abnormalities, and elevated levels of cardiac biomarkers (Derrick, 2009, p. 49), but a knowledgeable clinician can discriminate between the two by an absence of plaque rupture and coronary thrombosis, and complete reversibility (Wittstein, 2012, p. 1).
Formal diagnostic guidelines for TTC do not exist, but enough is known that several respected medical institutions have published their own (reviewed by Wittstein, 2012, p. 3). The Mayo Clinic bases a TTC...
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