Broken-heart syndrome patients increased risk

Broken-heart syndrome patients twice as likely to suffer further heart problems: New research from the University of Aberdeen found that re-admission to hospital for takotsubo patients was comparable to the re-admission rates for heart attack patients and double that of the general population.

Funded by the British Heart Foundation, the research has been published today in Annals of Internal Medicine.

Takotsubo cardiomyopathy affects around 5,000 people in the UK each year, and at least seven percent of all people who attend hospital with a suspected heart attack are subsequently diagnosed with broken heart syndrome.

The University of Aberdeen has led the way on research into the little-understood condition which was only recognised in the late 1990s.

The exact cause of the condition is not clearly understood but an acute episode can be triggered by severe emotional distress, such as the death of a loved one. As a result, when it was first discovered, it was also referred to as “broken heart syndrome”.

Researchers now believe it can be caused by a number of different factors, including intense physical trauma, but also lesser physical or emotional upsets or in some cases no incident at all.

Acute symptoms include shortness of breath and chest pain and as such it is often mistaken for a heart attack. It affects women and men of all ages with women more likely to experience the condition, and although significant recovery is possible, patients can often continue to experience long-lasting symptoms.

Professor Dana Dawson, Chair in Cardiovascular Medicine at the University, led this new research that used data from The Scottish Takotsubo Registry which records all cases of takotsubo in Scotland since January 2010. Currently, this is the only registry in the world with complete national data that includes details of the complete medical care of all takotsubo patients.

Results showed that of nearly 13,000 hospitalisations, the rate of readmissions of patients with takotsubo syndrome was 743 per 1000 person-years for patients with takotsubo syndrome, 365 per 1000 person-years for general Scottish population patients and 750 per 1000 person-years for patients with myocardial infarction.

Professor Dawson explains: “We know that people with takotsubo cardiomyopathy are more likely to die younger and that life expectancy is around the same as patients who have experienced a heart attack. But we don’t know what is causing this.

“We found that patients with takotsubo are twice as likely as the general population to be re-admitted to hospital and that figure is very similar to those who have experienced a heart attack.

“These re-admissions were usually for cardiovascular causes, mostly heart failure or irregular heart rhythms, but interestingly, also commonly for mental health reasons.

“Our findings highlight these patients’ vulnerability to further illness and need for better treatment and follow-up specific to their condition.”

Dr Sonya Babu-Narayan, Clinical Director at the British Heart Foundation and consultant cardiologist, said: “Because patients with Takotsubo syndrome may initially recover from their acute illness well, both in terms of their symptoms and their heart function, the seriousness of the condition may have previously been underestimated. But this study shows their readmission rates to hospital are increased compared to the general population and are almost at the same high level as people who have survived a heart attack.

“It is therefore vital that people with Takotsubo syndrome get the right tests and treatments when they need them. Further research is also crucial, so scientific breakthroughs can be made that will save and improve the lives of those living with this condition.”

Ameila Rudd, BHF-funded Allied Health Professional at the University who gathered and analysed the data added: “We found that takotsubo patients are at increased risk of experiencing ongoing symptoms such as breathlessness, chest pain and that their life expectancy is shortened.

“Our findings demonstrate that these patients remain vulnerable to continuing illness and that further research is still needed to improve their quality of life.”

Takotsubo cardiomyopathy

Takotsubo cardiomyopathy causes the left ventricle of your heart to change shape and get larger. This weakens the heart muscle and means it doesn’t pump blood as well as it should. It can develop at any age, but typically affects more women than men. Unlike some other cardiomyopathies, it’s not an inherited heart condition. Symptoms can often feel similar to heart attack symptoms However, unlike in a heart attack, patients don’t suffer from a blockage of the arteries that supply the heart with blood. It’s not known exactly what causes takotsubo, but it’s often brought on by emotional or physical distress.