Patient education: Stress cardiomyopathy (The Basics)

What is stress cardiomyopathy? — Stress cardiomyopathy is a heart condition that causes sudden chest pain, trouble breathing, or fainting (passing out). It happens most often in older females. It is often triggered by intense physical or emotional stress such as a sudden medical illness, the death of a loved one, or an argument. But it sometimes happens with without a clear trigger.

Stress cardiomyopathy is also sometimes called "stress-induced cardiomyopathy," "broken heart syndrome," or "takotsubo cardiomyopathy."

In stress cardiomyopathy, part of the heart stops working normally so the heart doesn't pump well. In most cases, the lower end of the heart, called the "apex," is involved. When this happens, this part of the heart gets bigger. Because of this, stress cardiomyopathy is sometimes called "apical ballooning syndrome."

Even though this condition causes symptoms similar to a heart attack, it is different from a heart attack. A heart attack happens most often in people with coronary heart disease (also called coronary artery disease). In a heart attack, an artery that supplies blood to the heart gets blocked. This causes part of the heart muscle to be damaged.

People with stress cardiomyopathy do not usually have coronary heart disease.

Stress cardiomyopathy is usually not long-lasting. Most people get completely better in 1 to 4 weeks. But sometimes, stress cardiomyopathy leads to serious heart problems, such as:

●Heart failure, which is a condition in which the heart does not pump well

●Heart rhythm problems that cause the heart to beat much faster or slower than normal

●Heart valve problems

What are the symptoms of stress cardiomyopathy? — The most common symptom is sudden chest pain. Some people have trouble breathing or faint (pass out).

Will I need tests? — Yes. Your doctor will ask about your symptoms and do an exam. Because the symptoms of stress cardiomyopathy are the same as those of a heart attack, your doctor will order tests to find out what's causing your symptoms.

These tests can include:

●Blood tests – During stress cardiomyopathy, the heart releases certain proteins. Blood tests can show whether these proteins are in your blood.

●A chest X-ray – This can show if there is fluid in the lungs. It also shows the general shape of the heart and large blood vessels in the chest.

●An electrocardiogram (also called an "ECG") – This test measures the electrical activity in the heart (figure 1).

●An echocardiogram (also called an "echo") – This test uses sound waves to create a picture of the heart as it beats (figure 2).

●Cardiac catheterization (also called "cardiac cath") – During this test, the doctor puts a thin tube called a catheter into a blood vessel in your leg or arm. Then they move the tube up to your heart (figure 3). When the tube is in your heart or blood vessels, they will take measurements. The doctor might also put a dye into a tube that shows up on an X-ray. This part of the test is called "coronary angiography." It can show if any of the arteries in your heart are narrowed or blocked.

How is stress cardiomyopathy treated? — Most people are treated with medicines. Your doctor can prescribe different heart medicines, depending on your symptoms and the problems caused by your cardiomyopathy.

People usually take some medicines for a short time only, until their condition improves. But some people take the medicines for life.

Most people with stress cardiomyopathy get better within 1 to 4 weeks and do not get this condition again. But some people who have had stress cardiomyopathy get the condition again.

More on this topic

Patient education: Chest pain (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: ECG and stress test (The Basics)
Patient education: Heart attack (The Basics)
Patient education: Cardiac catheterization (The Basics)
Patient education: Heart failure (The Basics)
Patient education: Ventricular tachycardia (The Basics)
Patient education: Bradycardia (The Basics)

Patient education: Chest pain (Beyond the Basics)
Patient education: Heart attack (Beyond the Basics)
Patient education: Heart failure (Beyond the Basics)