A type of non-ischemic cardiomyopathy, also known as Takotsubo cardiomyopathy or stress cardiomyopathy, in which there is a sudden temporary weakening of the muscular portion of the heart. The name comes from the Japanese word takotsubo, “octopus trap”, because the left ventricle of the heart takes on a shape resembling an octopus trap when affected by this condition.
Takotsubo syndrome (TTS) usually appears after a significant stressor, either physical (sepsis, shock…) or emotional; when caused by the latter, the condition is sometimes called broken heart syndrome. Reviews suggest that of patients diagnosed with the condition, about 70-80% recently experienced a major stressor including 41-50% with a physical stressor and 26-30% with an emotional stressor. TTS can also appear in patients who have not experienced major stressors.
A sudden massive surge of catecholamines, such as adrenaline and norepinephrine, is thought to play a central role in the TTS. Indeed, excess catecholamines, when released directly by nerves that stimulate cardiac muscle cells, have a toxic effect and can lead to decreased cardiac muscular function or “stunning”. Further, this adrenaline surge triggers the arteries to tighten, thereby raising blood pressure and placing more stress on the heart, and may lead to spasm of the coronary arteries that supply blood to the heart muscle. This impairs the arteries from delivering adequate blood flow and oxygen to the heart muscle.