Happy heart syndrome: role of positive emotional stress in takotsubo syndrome.

Abstract:

AIMS:Takotsubo syndrome (TTS) is typically provoked by negative stressors such as grief, anger, or fear leading to the popular term 'broken heart syndrome'. However, the role of positive emotions triggering TTS remains unclear. The aim of the present study was to analyse the prevalence and characteristics of patients with TTS following pleasant events, which are distinct from the stressful or undesirable episodes commonly triggering TTS. METHODS AND RESULTS:Takotsubo syndrome patients with preceding pleasant events were compared to those with negative emotional triggers from the International Takotsubo Registry. Of 1750 TTS patients, we identified a total of 485 with a definite emotional trigger. Of these, 4.1% (n = 20) presented with pleasant preceding events and 95.9% (n = 465) with unequivocal negative emotional events associated with TTS. Interestingly, clinical presentation of patients with 'happy heart syndrome' was similar to those with the 'broken heart syndrome' including symptoms such as chest pain [89.5% (17/19) vs. 90.2% (412/457), P = 1.0]. Similarly, electrocardiographic parameters, laboratory findings, and 1-year outcome did not differ. However, in a post hoc analysis, a disproportionate higher prevalence of midventricular involvement was noted in 'happy hearts' compared with 'broken hearts' (35.0 vs. 16.3%, P = 0.030). CONCLUSION:Our data illustrate that TTS can be triggered by not only negative but also positive life events. While patient characteristics were similar between groups, the midventricular TTS type was more prevalent among the 'happy hearts' than among the 'broken hearts'. Presumably, despite their distinct nature, happy and sad life events may share similar final common emotional pathways, which can ultimately trigger TTS.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Ghadri JR,Sarcon A,Diekmann J,Bataiosu DR,Cammann VL,Jurisic S,Napp LC,Jaguszewski M,Scherff F,Brugger P,Jäncke L,Seifert B,Bax JJ,Ruschitzka F,Lüscher TF,Templin C,InterTAK Co-investigators:.

doi

10.1093/eurheartj/ehv757

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

2823-2829

issue

37

eissn

0195-668X

issn

1522-9645

pii

ehv757

journal_volume

37

pub_type

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