Translated from Japanese, the word "takotsubo" is a special device for catching octopuses in the open sea, and it is this form( spherical with a narrow neck) that appears when the disease in question occurs.
Representing a cardiac pathology of the upper part of the left ventricle, takotsubo cardiomyopathy is also called "broken heart syndrome".The peculiarity of such a pathological condition is the emergence of myocardial weakness, which can occur when a severe unexpected stress is transferred, for example, with the sudden death of a loved one. Knowing the specifics of this condition, you can notice the onset of the disease in time and reduce the likelihood of adverse health effects.
Features of the disease
In stressful cardiomyopathy, the following consequences may occur:
- acute heart failure;
- lethal ventricular arrhythmias;
- rupture of ventricular walls.
The sudden manifestation of this state of cardiac pathology is revealed in the form of sharp pains in the chest, acute heart failure, which can help in time to identify the emergence of a serious illness, life-threatening patient. With the help of ECG studies, it becomes possible to identify the initial stage of takotsubo cardiomyopathy.
The disease is most often diagnosed in the female half of the population, whose age ranges from 40 to 55 years, that is, during the menopause. And in winter the disease progresses more often.
Echocardiogram for takotsubo
Forms of
When this condition occurs, there is no contraction of the upper part of the ventricle with excessive reduction of the basal parts.
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Two main forms of tacotubo cardiomyopathy have been identified, including:
- Apical partial( moderate) variant, which is usually seen in people in middle age - from 30 to 45 years.
- The Takotsubo syndrome is reversed, in which a full akinesia of the basal segments of the ventricle and the hyperdynamicity of its upper part are observed in women at a young age. This type of disease is considered to be more rare and rarely detected.
There are a number of provocative factors that can cause this condition and cause a significant deterioration in human health.
More details and details about the features of the broken heart syndrome will be described by E. Malysheva in her video:
The causes of cardiomyopathy takotsubo
The most common manifestations of takotsubo cardiomyopathy start to manifest themselves when exposed to the following factors:
- significant moral and psychological overloads, stressful conditions;
- physical exertion, exceeding the capacity of the body;
- occurrence of an excessive cerebral pressure - it can be ischemic strokes massive, the use of sympathomimetics, TBI, hemorrhagic strokes.
The reason for the development of bulging of the top of the left ventricle is an increase in the level of catecholamines in the blood of a person, predominantly high is the amount of adrenaline released into the blood. At the same time, the development of this pathological condition has not been fully understood to date;it is assumed that a significant role is played by vasospasm arising from the release of adrenaline after emotional stress, in which there is a sharp deterioration in blood microcirculation in the heart vessels and arteries.
There are a number of risk factors that can trigger this pathological condition. These include the following:
- abuse of alcohol and nicotine, which usually accompanies the emergence of stressful situations;
- presence of a source of stress in the family or in the workplace( this may be domestic violence);
- chronic anxiety;
- sharp drop in blood pressure;
- conduct medical procedure or surgical intervention.
Stress, most often the primary cause of takotsubo cardiomyopathy, can be caused by public speaking, loss of close relatives, asthma attacks, bad news, accident.
Symptoms of Broken Heart Syndrome
The manifestations of this cardiac pathology are similar to acute heart failure and manifest mainly in the form of dyspnea and acute chest pain. Tachycardia and periodic loss of consciousness may also occur.
The following symptoms of this condition are also revealed during the examination:
- manifestations of ischemic changes during ECG;
- low level of cardiac biomarkers in comparison with the degree of dysfunction in the left ventricle;
- sensations of soreness in the chest immediately after any kind of overload - physical and psychological;
- absence of thrombosis of the heart vessels or small changes in the functions of the coronary arteries.
The general picture of the disease may look like this: there is a pronounced bulging of the left ventricle, while hyperkinesis of its base is observed. At the same time, the necessary functions of the base of the ventricle are fully preserved.
And so that this condition does not cause serious violations in the work of the heart system, it is necessary to diagnose in time and make a correct diagnosis. What methods of detection of cardiomyopathy are used today?
Diagnosis of the disease
- Coronary angiography is used as the most effective examination for a patient with a suspicion of takotsubo cardiomyopathy. With this type of study, it becomes possible to identify the presence of hemodynamically significant stenoses, which lead to the onset of serious disorders in the operation of the left ventricle of the heart.
- Angography as one of the most valuable methods of diagnosing this pathology allows us to identify the difference between takotsubo cardiomyopathy and acute coronary insufficiency.
- ECG allows to reveal visible disturbances in the work of the heart: violation of the rhythm of its work, speed and rhythm of contraction of the walls of both ventricles. However, with ECG, the detected changes can be diagnosed as acute heart failure, and also as anterior myocardial infarction.
Treatment of
Therapeutic treatment for this lesion of the cardiac system is not carried out - the most effective method of treatment here is the use of certain medications that can relieve pain and restore normal functioning of the heart. Therapeutic impact on the patient can only be provided in preventive and supportive directions.
Drug method
The acute period of the disease is usually stopped by the appointment after a survey of tranquilizers that help in a short time to relieve pain. This method is used for the preceding emotional or physical stress.
The following medicines are also prescribed for treatment:
- ACE inhibitors;
- diuretics;
- anticoagulants;
- calcium antagonists.
Balloon intra-aortic counterpulsation
One of the treatment methods is also considered the implementation of balloon intra-aortic counterpulsation. The duration of the treatment applied directly depends on the rate of recovery of the normal functioning of the heart. Nitrates are also prescribed, which eliminate the spasms of the coronary vessels.
Folk methods do not provide an opportunity to reduce the severity of the condition in a timely manner, therefore can not be recommended for use in the detection of takotsubo cardiomyopathy.
Prevention of the disease
The preventive measures of this pathological condition include the removal of the nervous environment at home and in the workplace and, if possible, exclude disease-provoking factors: reduce or stop taking alcohol and nicotine, optimize work and rest, exclude violence in the family.
On the possibility of death from cardiomyopathy, the symptoms of complication with it read further.
Complications of
If untimely detection of the disease, a number of serious complications can occur that can cause significant harm to the patient's health until death.
The most common complications of this condition include the following:
- development of shock;
- mitral regurgitation;
- occurrence of apical thrombosis;
- stroke.
When preparing the prognosis, it is necessary to take into account such data as patient's age, general condition and accepted treatment.
Forecast
When takotsubo cardiomyopathy occurs, acute heart failure often occurs in people over 70 years of age, with a physical stress factor.
Survival in this secondary cardiomyopathy is 85-97% with timely diagnosis, and the normal functioning of the left ventricle is restored after 2 months from the start of treatment.
More useful and interesting information on the issue of broken heart syndrome contains the following video: