Cardiologists at Lahey Clinic publish findings on takotsubo, syndrome that mimics heart attack mostly in menopausal women

Release Date: 08/10/2009

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Margie Coloian
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Cardiologists at Lahey Clinic publish findings on takotsubo, syndrome that mimics heart attack mostly in menopausal women

BURLINGTON, MA—In an article appearing in this month's American Journal of Cardiology, Lahey Clinic Medical Center cardiologists publish their five-year study findings on takotsubo cardiomyopathy, a rare but increasingly diagnosed disease that mimics a heart attack mostly in menopausal women after they experience a stressful event, like the death of a loved one or job loss.

Takotsubo, from the Japanese, means octopus trap. The syndrome, first detected in Japan in the 1990s, is named for the globular misshape that the heart ventricle takes in affected patients.

For the study, 34 patients were identified retrospectively with the syndrome from more than 9,000 patients who had had left heart catheterization at the medical center between May 2002 and November 2007. All patients had presented through the emergency department and were suspected of having a heart attack initially, but they had no obstructive coronary artery disease.

Unlike a heart attack, though, takotsubo involves no lasting damage to the heart muscle and most patients, including those in the study, recover with practically no residuals.

The study was led by Richard W. Nesto, MD, chair of the Department of Cardiovascular Medicine. “In about 95 percent of cases,” said Nesto, “the patient actually has a full recovery. And we have not seen any recurrences.”

In the Lahey study, 94 percent (32) of takotsubo patients were female, and 88 percent (28) were 50 years of age or older. Some 82 percent had reported a previous stressful event before presenting. Of these patients, 35 percent said the stressor was emotional—like a relative's death, divorce, or financial crisis, and 47 percent said the stressor was physical—citing long distance travel, physical assault, or an existing uncontrolled medical condition. Only nine patients, or 24 percent, had no identifiable stressors.

Treatment for takotsubo patients is similar to that rendered to heart attack patients, including aspirin and beta blocker therapies. All the patients in the study underwent coronary angiography, most with favorable outcomes.

The study validates other studies of its kind: This is a very rare condition, afflicts older women who are at low risk for cardiac disease, and comes about after extreme stress. Researchers believe between 0.7 to 2.5 percent of all patients with acute coronary distress may actually have takotsubo—perhaps as many as 30,000 cases every year in the United States.

Cause of the disease remains unclear.

About Lahey Clinic
Lahey Clinic, a physician-led, nonprofit group practice, is world-renowned for innovative technology, pioneering medical treatment, and leading-edge research. A teaching hospital of Tufts University School of Medicine, the Clinic provides quality health care in virtually every specialty and subspecialty, from primary care to cancer diagnosis and treatment to kidney and liver transplantation.