Cause of Broken Heart Syndrome Found with Contrast Echocardiography

Kathleen Blanchard's picture

Researchers have explored the cause of broken heart syndrome, medically known as Tako-Tsubo Syndrome. Scientists now have further explanation regarding the cause of the disease that mimics heart attack (myocardial infarction) and is somewhat of a peculiarity, diagnostically challenging, and rare.

Broken heart syndrome, also called broken heart disease, produces the same symptoms as heart attack, but when coronary angiography (cardiac catheterization) is performed, no blockages in the arteries that supply blood flow to the heart are found. In eighty percent of cases, broken heart syndrome is preceded by extreme stress -thus the name.

Filippo Crea and colleagues from the Department of Cardiovascular Medicine of the Catholic University of Rome studied 68 post menopausal women – the largest group affected by Tako-Tsubo Syndrome, discovering the mechanism that leads to the syndrome


"In 80% of the patients, symptoms disappear spontaneously after a couple of weeks, leaving no trace behind", explains Filippo Crea, "whilst in the other cases the damage persists. The fact is that the damage caused by this syndrome is in the heart but not in the coronaries. What we have tried to explain is the mechanism which leads to the onset of these symptoms".

The research group found that symptoms of broken heart syndrome occur from spasm in the small blood vessels, or microvascular circulation that supplies blood to the heart, currently believed to be the result of adrenalin effect on the heart muscle.

Tako-Tsuboand Syndrome causes the heart to take on a balloon shape. Researchers say they focused on the apex of the heart - the left lower region, "because that is the area where the dysfunction is localized. Due to this, the heart takes on the characteristic shape of an air balloon, or – as the Japanese observed – of a local octopus trap. The Tako-Tsubo is as a matter of fact the name of this pot in Japanese."

Using an inexpensive bedside technique, myocardial contrast echocardiography, allowed the researchers to pinpoint intense constriction of microvascular circulation that occurs with broken heart syndrome. Tako-Tsubo Syndrome does not usually result in any heart damage. The authors say microvascular coronary spasms that restrict blood flow to the heart and cause chest pain are reversible.

European Heart Journal