According to recent estimates, in Western countries, 2-3% of all subjects who experience the symptoms of a heart attack would be interested. In 90% of cases, these are women aged between 58 and 75. Also known by the name of broken heart syndrome, the sindrome di Takotsubo it is a suffering, usually temporary, of the heart which recalls the symptoms of the heart attack and which is triggered by a very intense emotional or stressful situation. To describe the disorder, in the early 90s of the twentieth century, some researchers from Japan. ‘Takotsubo’, in fact, is a Japanese word that refers to a kind of basket used by fishermen to catch octopuses. As the latter, in fact, the patient’s left ventricle appears during echocardiographic investigations. Pathology is an example of non-ischemic cardiomyopathy.
The cause precise of Takotsubo syndrome is not yet known, however, as already mentioned, it would seem to be the result of a particularly stressful event or a strong emotion. Such situations cause a huge release of adrenaline and norepinephrine. This hormonal cascade, in predisposed individuals, impairs the blood pumping function of the left ventricle of the heart. The main triggers of stress cardiomyopathy have been observed to include: death of a loved one, separation or divorce, diagnosis of a serious illness, domestic violence, job loss. Still financial problems, public speeches, surprise parties, physical stresses (asthma attacks, major surgery, bone fractures). Do not underestimate the intake of some drugs (epinephrine, levothyroxine, duloxetine, venlafaxine) whose effect is to raise the levels of adrenaline and / or norepinephrine.
I symptoms of Takotsubo syndrome, which can appear within a few minutes of the stressful event or after a few hours, can be superimposed on those of a heart attack: sharp and sudden chest pain, feeling faint, shortness of breath. Unlike the heart attack, however, the coronary arteries do not have atheromas inside them that prevent the flow of blood. Generally the disturbance is temporary and does not cause long-term repercussions. In some circumstances, however, it may happen that it turns into a serious heart condition and gives rise to complications including: hypotension, pulmonary edema, arrhythmias and even cardiac arrest. The sudden appearance of clinical signs such as chest pain and dyspnoea should prompt immediate medical attention.
Researchers from the Cleveland Clinic (Ohio) wanted to investigate the possible relationship between Takotsubo syndrome and the Coronavirus. The data of the studio, the latter published in the Journal of the American Medical Association, make you think. Scientists analyzed two thousand patients admitted from 2018 to today in the coronary units of the hospitals belonging to the Cleveland Clinic and divided them into two categories: those hospitalized in the pre-Covid period and those admitted in the Covid period (March-April 2020). Except for a greater presence of hypertensives in the group of the pre-Covid period, there were no significant differences, both as regards the associated pathologies and for the age.
There was therefore an average of 1.5% of patients with broken heart syndrome in the pre-Covid period and about 8% in the Covid period. Two le hypothesis. The first is that Coronavirus acts directly on small vessels, as well as on cardiac muscle cells, causing a generalized spasm. The second, the most probable, suggests instead that the origin of the syndrome should be sought in the fear of contracting the infection and in the tension caused by the change of life (fear for the future, anxiety for the health of loved ones, social isolation, use masks).
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