Broken Heart Syndrome (Takotsubo Cardiomyopathy)

Broken heart syndrome, also known as takotsubo cardiomyopathy or stress cardiomyopathy, is a sudden weakening of the heart’s pumping function. The word “takotsubo,” which means an octopus trap in Japanese, refers to the abnormal ballooning shape of the heart.

Triggered by emotional or physical stress, broken heart syndrome mimics the symptoms of a heart attack. UT Southwestern Medical Center’s experienced team of heart doctors combine their skill and experience with the newest science-based tools and techniques to expertly diagnose and treat it.

A Real, Yet Sometimes Mysterious Condition

The exact cause of broken heart syndrome isn’t fully understood, but many believe it can be triggered by emotional or physical stress, which leads to release of stress hormones. The stressor might be a traumatic event, such as the death of a loved one, or something that causes the patient to worry, such as an upcoming surgery. As an example, there have been reports of patients developing broken heart syndrome out of overwhelming fear of the COVID-19 virus. However, in many cases, a specific trigger is never identified.

A temporary condition, broken heart syndrome disproportionately affects women in their 50s or older. Patients may believe they are having a heart attack, but upon examination, there are no blockages in the heart vessels. Treatment is important, however, and getting emergency care can reduce the risk of heart failure, severe arrhythmia, or blood clots that could lead to a stroke.

Diagnosing Broken Heart Syndrome

There’s no way to know at home whether symptoms are related to anxiety or a heart attack, so seeing a doctor is important. If you’re experiencing chest pain or shortness of breath, call 911. Cardiologists can perform specific tests to determine what’s wrong and provide appropriate care.

Common diagnostic tests to rule out a heart attack and confirm broken heart syndrome include:

• Cardiac enzyme studies: To show if heart muscle was destroyed
• Electrocardiogram (ECG or EKG): To look for time elevations or depressions at the end of the ventricles’ contractions (lower heart chambers) and evaluate the time of the recovery period
• Coronary angiogram: To check if there’s a restriction or blockage in blood flow, using X-ray imaging to view the heart's blood vessels
• Physical exam: To check for low blood pressure, high heart rate, or a new mitral regurgitation murmur

Treating Broken Heart Syndrome

Typically, our team will prescribe the same kinds of medications for broken heart syndrome as we would for a patient who has had a heart attack – mainly ACE inhibitors, or angiotensin-converting enzyme inhibitors. Beta blockers may also be used.

More severe cases may require blood thinners (if there are clots in the heart), or the treatment of abnormal heart rhythms. A small percentage of people develop shock and may require special medications to increase the pumping function of the heart, or mechanical pumps to support the heart.

We also help the patient work through any situations that may be causing stress. Most of the time, this combination of medication and removing stress helps the patient’s heart function return to normal, and many patients recover without any lasting damage.

Support Services

UT Southwestern’s cardiac rehabilitation specialists create customized plans that integrate proper nutrition, exercise, and, if necessary, nicotine cessation into patients’ lifestyles to improve their cardiovascular health.