What Is Stress Cardiomyopathy?

stressed woman with head in hands sitting in an office

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What Is Stress Cardiomyopathy?

Stress cardiomyopathy is a condition in which severe emotional or physical stress causes the heart muscles to weaken quickly and sometimes severely.

Emotional stressors that cause this condition could be grief, fear, or surprise, while physical stressors that may lead to stress cardiomyopathy include asthma or pain from an accident. 

Stress cardiomyopathy is also known as “broken-heart syndrome” or takotsubo cardiomyopathy. Although complications might occur, people with this condition are usually able to make a full recovery in a couple of weeks. It also causes no permanent damage to the heart, unlike other heart conditions. 

It can occur at any age but has been observed to affect more women than men. It’s a rare form of cardiomyopathy. According to the American College of Cardiology, 15 to 30 cases of the condition occur in every 100,000 heart conditions, each year in the United States. However, this number could be higher, as milder forms are less likely to be reported or receive medical treatment.

Symptoms 

The most common symptoms of stress cardiomyopathy are very similar to the symptoms of a heart attack and can occur suddenly.

Unlike a heart attack, which kills heart cells, this form of cardiomyopathy temporarily stuns heart cells. This makes recovery from the condition quicker than recovery window following a heart attack. Common symptoms include: 

  • Shortness of breath
  • Chest pain 
  • Nausea 
  • Vomiting 
  • Fatigue 
  • Low blood pressure 
  • Dizziness
  • Irregular heartbeats
  • Cardiogenic shock (an inability of your heart to pump enough blood to meet your body’s demands)

Diagnosis 

When being diagnosed, stress cardiomyopathy may be mistaken for a heart attack because of its shared symptoms. In some cases an electrocardiogram (ECG), may even show similar abnormalities in the heart of a person with stress cardiomyopathy as in the heart of a person who has had a heart attack. 

In most cases the condition isn’t fatal and people who get it only need adequate rest and support to make a full recovery. However, in rare cases, it can cause complications such as heart failure or low blood pressure.

To ensure that a proper diagnosis is made, a medical professional will lookout for the following: 

  • That there is no evidence of a blockage in the coronary arteries (this is one of the most common causes of a heart attack)
  • If there’s an abnormal movement or ballooning in the muscles of the left ventricle (the part of the heart stress cardiomyopathy affects)
  • If there’s a slight rise in cardiac biomarkers (substances released into the blood when the heart is either damaged or stressed)
  • If an emotional or physical trigger, or a combination of both, occurred shortly before the condition developed (this isn’t obligatory)
  • If you are postmenopausal; statistics show that women who are postmenopausal stand a high risk of developing the condition

Stress cardiomyopathy isn’t always caused by a stressful event. Some cases of the condition have no identifiable triggers. 

Causes

The exact cause of stress cardiomyopathy is unknown. Research shows that a sudden surge in stress hormones like adrenaline is capable of stunning the heart’s muscles.

This causes changes in the cells of the heart muscles and causes the left ventricle to balloon and change shape, preventing the heart from working properly.

The word “takotsubo” is derived from a Japanese octopus trap. The shape of the left ventricle is similar to that of the trap when this occurs. This is why the condition is also known as takotsubo cardiomyopathy or takotsubo syndrome.

Stress cardiomyopathy is often brought on by emotional or physical stressors. Emotional stressors that may be lead to stress cardiomyopathy include: 

  • Death of a loved one 
  • Loss of a job 
  • A sudden surprise like a surprise party 
  • Financial loss 
  • Assault 
  • Living through a natural disaster 

Physical stressors like an illness or undergoing surgery are also a leading cause of the condition. Some of them include: 

  • A sudden drop in blood pressure 
  • A serious accident 
  • A critical illness 
  • Experiencing severe pain 
  • Surgery

Types

Stress cardiomyopathy can be split into two subtypes—primary and secondary:

Primary

A person with the primary form of stress cardiomyopathy isn’t already under healthcare supervision and can typically be treated with anticoagulant agents like aspirin.

Secondary

A person with the secondary form of the condition, would usually already be under healthcare supervision as a result of another condition like hypotension or acute pulmonary edema. This often makes diagnosing stress cardiomyopathy more difficult.

Who Is at Risk?

Stress cardiomyopathy is up to nine times more prevalent in women than in men. Age also plays a great role in determining who is at risk of developing the condition.

People over the age of 50 are thought to be the most at risk, although it can occur at a younger age.

Postmenopausal women are also thought to be at a higher risk of developing the condition especially shortly after they’ve experienced sudden and severe emotional stress.

Some conditions that might put you at risk of the disease include:

  • Diabetes Mellitus: Research shows that 10 to 15% of people who have diabetes mellitus, also known as type 2 diabetes develop stress cardiomyopathy. 
  • Asthma: An asthma attack is another possible trigger. The condition could occur after there has been serious medical intervention like an intubation.
  • Cannabis use disorder: Those dealing with cannabis use disorder are at an increased risk of developing the condition. 

Treatment

People who've dealt with stress cardiomyopathy experience no long term damage to their heart. Recovery from this condition usually takes a couple of days to weeks.

Treatment for this condition differs from person to person and typically depends on the severity of a person’s symptoms. Medications such as beta-blockers and ACE inhibitors might be prescribed for patients with more severe symptoms. 

A combination of alpha and beta-blockers might also be prescribed as a long-term treatment plan to prevent a reoccurrence. The alpha and beta-blockers help to reduce the effects of stress hormones on the heart. 

It’s possible for the condition to reoccur, even after you’ve made a full recovery. The condition can be life-threatening in certain cases. The weakening of the heart muscles might cause other complications like heart failure and low blood pressure.

Coping

Stress cardiomyopathy is a reversible condition. This means for many people your heart will return to normal in a couple of weeks with little or even no medical intervention.

It’s important to recognize the things that cause stress and manage them. You should also minimize stressful triggers until a full recovery is made. 10 to 15% of people who have had the condition develop it again.

Managing stress is not only a great way to cope with the condition, it’s great for your overall health too. Here are some ways you can do so: 

  • Eat a balanced diet 
  • Exercise regularly 
  • Get rid of stress triggers you have control over
  • Take some things off your plate
  • Talk about your feelings
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Article Sources
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  1. Ramaraj R. Stress cardiomyopathy: aetiology and management. Postgrad Med J. 2007;83(982):543-546.

  2. Stress cardiomyopathy diagnosis and treatment. American College of Cardiology.

  3. Zidwick V. Stress cardiomyopathy symptoms | heart and vascular institute.

  4. Medina de Chazal H et al. Stress cardiomyopathy diagnosis and treatment: Jacc State-of-the-art Review. Journal of the American College of Cardiology. 2018;72(16):1955-1971.

  5. Publishing HH. Takotsubo cardiomyopathy (Broken-heart syndrome). Harvard Health.

  6. Ramaraj R. Stress cardiomyopathy: aetiology and management. Postgraduate Medical Journal. 2007;83(982):543-546.

  7. Medina de Chazal H, Del Buono MG, Keyser-Marcus L, et al. Stress cardiomyopathy diagnosis and treatment. Journal of the American College of Cardiology. 2018;72(16):1955-1971.

  8. What is Takotsubo (Broken heart syndrome)? Heart Foundation NZ.