Stress Cardiomyopathy, Takotsubo cardiomyopathy
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Stress Cardiomyopathy/ Takotsubo Cardiomyopathy

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - What it is

Stress cardiomyopathy (also known as takotsubo cardiomyopathy or ‘broken heart’ syndrome) happens when a person experiences sudden and intense stress or emotional changes, causing the heart muscle to weaken very quickly. Various life events such as losing a loved one, extreme sadness or happiness can bring about this condition. The weakened heart is unable to pump properly. This results in symptoms which can mimic a heart attack or heart failure. This condition usually responds well to medication and recovery is expected with time.

Possible complications of stress cardiomyopathy

People with stress cardiomyopathy usually recover without long-lasting effects. However, in rare cases, stress cardiomyopathy can cause severe weakness in the heart muscle, leading to life-threatening complications such as:

  • Heart failure
  • Extremely low blood pressure
  • Abnormal dangerous heart rhythm 
  • Blood clots in the heart chamber

It is possible for people to experience a recurrence of stress cardiomyopathy though this is extremely rare. 

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - Symptoms

Symptoms of stress cardiomyopathy mimic those of a heart attack such as:

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - How to prevent?

Stress cardiomyopathy might be prevented through better stress and emotional management. Making lifestyle changes and seeking help when necessary can help reduce unnecessary stress, and decrease the chances of developing stress cardiomyopathy. 

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - Causes and Risk Factors


The exact cause of stress cardiomyopathy is unknown. It is generally thought to be caused by a surge of stress hormones, such as adrenaline, that suddenly causes the heart to temporarily enlarge, decrease the pumping action and possibly restrict one or more of the coronary arteries.

Stress cardiomyopathy tends to happen after intense physical or emotional events. Some examples of such events include:

  • Physical events: Sudden illnesses, injuries or major operations. 
  • Emotional events: Big arguments, intense fear, death of a loved one or other kinds of loss.

In some rare cases, the use of certain drugs or medications might also lead to stress cardiomyopathy. 

Stress cardiomyopathy is different from a heart attack. A heart attack is usually caused by acute cessation of blood flow in one of the coronary arteries due to blood clots formed on a ruptured cholesterol plaque. In stress cardiomyopathy, the arteries are not blocked but blood flow in the arteries may be reduced.

Risk factors

Even though the exact cause of stress cardiomyopathy is unknown, there are certain risk factors that might increase one’s chances of getting it. These include: 

  • Age: Those who are above the age of 50, especially post-menopausal women, are at higher risk of getting stress cardiomyopathy. The exact reason for this is not known, but it is thought that the female hormone oestrogen helps to protect the heart from any harmful effects of adrenaline. When women go through menopause, their oestrogen levels decrease, thus increasing their risk of developing this condition. 
  • Gender: Women are more likely than men to have stress cardiomyopathy.
  • Past or current mental health disorders: Those with a history of mental health disorders such as anxiety or depression have a higher risk of developing stress cardiomyopathy. 

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - Diagnosis

The doctor will perform an initial evaluation on the patient before ordering tests to check for stress cardiomyopathy.  

Some initial diagnostic tests can include: 

  • Electrocardiogram (ECG): This measures your heart’s electrical activity which can differentiate between stress cardiomyopathy and a heart attack. 
  • Coronary angiography: This is a minimally invasive test which is done to rule out the possibility of a heart attack. A dye will be injected into the blood vessels of the heart before moving X-ray images are taken. Patients suffering from a heart attack often have obstructions in their blood vessels, which can be seen in the X-ray. However, those suffering from stress cardiomyopathy usually do not have blocked blood vessels. 
  • Echocardiogram: This is an ultrasound scan for assessment of heart function.
  • Cardiac Magnetic Resonance Imaging (MRI): This creates detailed images of the heart structure, and may help to differentiate stress cardiomyopathy from other conditions that can cause a weak heart function. 

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - Treatments

Since there is no standard treatment for stress cardiomyopathy, the management strategy would follow that of a heart attack until the doctor is able to ascertain that one is having stress cardiomyopathy. Once verified that it is due to stress cardiomyopathy, doctors may prescribe medications to help the heart pump better and reduce stress on the heart until the heart recovers. Managing stress using relaxation techniques can also be very useful for recovery. 

Surgical procedures used for heart attacks, such as angioplasty or coronary artery bypass surgery, are not necessary as there is usually no blockage in patients with stress cardiomyopathy. 

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - Preparing for surgery

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - Post-surgery care

Stress Cardiomyopathy/ Takotsubo Cardiomyopathy - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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