Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study offers clues to 'Broken Heart Syndrome'

14.05.2007
Largest US registry of patients with takotsubo cardiomyopathy aids physicians in diagnosis, management

The causes of "broken heart syndrome" remain a mystery, but doctors will soon have an easier time recognizing and treating this rare, life-threatening condition, thanks to data being reported at the 30th Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI), May 9–12, 2007, in Orlando, FL.

Researchers from Brown University in Providence, RI, have developed the largest registry of patients in the United States with Takotsubo cardiomyopathy, informally known as broken heart syndrome because it is often preceded by an emotional or physical shock of some kind and almost always strikes women. One thing is certain: Patients are usually critically ill during the first 48 hours.

"These patients can be difficult to manage for emergency physicians and cardiologists alike," said cardiology fellow Richard Regnante, M.D. "They may be in cardiac arrest, cardiogenic shock, or severe heart failure. They may require advanced life support with airway management and medications to support blood pressure."

In fact, based on symptoms, electrocardiographic (ECG) tracings, and blood tests for heart damage, it often seems as if the patient is having a heart attack. The mystery deepens in the cardiac catheterization laboratory, when the interventional cardiologist finds no blockage in the coronary arteries.

To date, the registry has enrolled 40 patients diagnosed with Takotsubo cardiomyopathy at two major hospitals in Rhode Island over a period of nearly 2½ years. Ninety-five percent were women, and 60 percent experienced some type of stress shortly before coming to the emergency room. The intensity of the stress varied dramatically, however, ranging from armed robbery to a heated argument, tooth extraction, or preparation for a colonoscopy.

"We don't know why some women develop this syndrome after what appears to be minimal stress, while other women experience severely stressful events but don't develop Takotsubo cardiomyopathy," Dr. Regnante said. A surge of stress hormones likely plays a role, he said, but it is also possible that a blood clot temporarily blocks a major artery of the heart, then dissolves before being detected during coronary angiography.

The most common symptom of broken heart syndrome was chest pain, in 70 percent of patients, followed by shortness of breath in 33 percent. All patients had ECG changes suggestive of an acute coronary syndrome, a term that encompasses both heart attack and unstable angina. Troponin-I, a blood test for heart damage, was positive in 95 percent of patients. Twenty percent of patients were unable to breathe on their own and needed a respirator. In all patients, cardiac catheterization showed characteristic abnormalities in the motion of the heart. One patient died of acute heart failure.

The good news is that most patients who survived the first 48 hours had a steady recovery. Thirty one, or 78 percent, of patients had follow-up echocardiography within a few weeks. Heart function was found to be normal in 29 of 30.

Dr. Regnante said that long-term follow-up will be critical to improved understanding of Takotsubo cardiomyopathy. In addition, he and his colleagues are gathering information on patients who have intravascular ultrasound during cardiac catheterization. This imaging test, in which a tiny ultrasound probe is threaded into the coronary arteries on the tip of a catheter, may show whether the patient has clogged arteries or unstable plaques that are not visible on coronary angiography. These findings will help guide long-term treatment.

"Because we don't yet know what causes this phenomenon, we don't know what the best long-term management should include," he said. "As we gather more information on these patients, we can start to understand who is affected by Takotsubo cardiomyopathy, offer more focused long-term care, and make predictions about their outcomes."

Kathy Boyd David | EurekAlert!
Further information:
http://www.scai.org

More articles from Studies and Analyses:

nachricht Amputees can learn to control a robotic arm with their minds
28.11.2017 | University of Chicago Medical Center

nachricht The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Plasmonic biosensors enable development of new easy-to-use health tests

14.12.2017 | Health and Medicine

New type of smart windows use liquid to switch from clear to reflective

14.12.2017 | Physics and Astronomy

BigH1 -- The key histone for male fertility

14.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>