Tako-tsubo syndrome: heart almost broken by pain

This article is from the magazine Les Indispensables de Sciences et Avenir n°210 dated July/September 2022.

After an emotional shock – sudden loss of spouse, violent attack, road accident – it happens that the heart muscle contracts abnormally, usually 24 hours after the trauma. The pain in the chest is so intense that the person who suffers from it must be hospitalized urgently. It’s the syndrome of tako tsuboor stress heart disease. “We have to make sure as soon as possible that it is not a heart attack: thanks to imaging tests, we check that the heart arteries are not clogged”explains cardiologist Antoine Sauguet, from the Chest Pain Center at the Pasteur Clinic in Toulouse.

The heart which takes a very specific form of amphora or octopus trap

Ultrasound reveals that the heart has taken on a very specific shape of an amphora or octopus trap (literal translation from Japanese tako tsubo). If the tako tsubo is not directly fatal, and heals spontaneously in a few days to a few weeks, it is nonetheless dangerous because of its possible complications. “We fear that the abnormal contraction of the heart will cause a rhythm disorder which can lead to a cardiac arrest. The patient remains in the hospital under surveillance for a week.continues the cardiologist.

Under stress, the left ventricle deforms with each contraction, taking on the shape of an “octopus trap”, which is not very effective in pumping blood. Credits: CLEVELAND CLINIC 2021

Anyone, at any age, can be hit by a tako-tsubo

Who can be affected? Everyone, at any age, including very healthy people. “And more when one has already suffered a tako tsubo. This is the only risk factor identified to date, without anyone understanding why. “, specifies Antoine Sauguet. Just as we cannot explain why nine out of ten people affected are women over 50. Moreover, the mechanism at the origin of the tako tsubo itself remains mysterious. It is assumed that in the face of a traumatic event, nerve cells discharge into the blood a phenomenal quantity of catecholamines, molecules that regulate heart rate and blood pressure, which lead to a cascade of reactions that end with contraction anomalies mimicking an heartstroke.

By Marine Cygler

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