People who experience a rare condition known as "broken-heart syndrome" require immediate medical attention, but often recover quickly. But the problem can be especially fatal if these patients also develop a complication in which their heart can not pump enough blood to the body, according to a new study.
Moreover, the risk of death of patients with a broken heart syndrome with this complication – known as cardiogenic shock – remains high, not only during their stay in the hospital, but years later.
"Beyond the higher short-term mortality, this analysis found for the first time that people who had experienced a broken heart syndrome, complicated by cardiogenic shock, had a high risk of death years later, which underlines the importance of careful long-term follow-up, especially in these patient group, "Dr. said. Christian Templin, lead author of the study and head of acute cardiac care at the University Heart Center of the Zurich University Hospital in Switzerland, in a statement.
The findings will be presented during the Scientific Sessions meeting of the American Heart Association in Chicago and simultaneously published in the journal Circulation. [9 New Ways to Keep Your Heart Healthy]
The syndrome of the broken heart, also known as takotsubo syndrome, is a condition in which the main chamber of the heart, the left ventricle, is temporarily enlarged and weakened so that it does not pump properly. (The syndrome is named after the strange shape that the heart takes when the ventricle is enlarged.It looks like a "takotsubo", a Japanese fish pot used to confine octopuses.) The condition is often caused by emotional stress, such as the death of a loved one or the loss of a job, according to the Mayo Clinic. But it can also be caused by physical stress, such as an asthma attack or a major operation.
Symptoms of a broken heart syndrome may resemble those of a heart attack and include chest pain and shortness of breath. But unlike a heart attack, there is no blockage of the arteries of the heart and patients usually make a full recovery within days to weeks, says the Mayo Clinic.
But about 1 in 10 patients with a broken heart syndrome experience cardiogenic shock, a life-threatening complication where the heart suddenly can not pump enough blood to meet the needs of the body.
A complicated broken heart
In the new study, the researchers wanted to better understand how patients do when they develop heart disease with cardiogenic shock and which treatments can help these patients.
The researchers analyzed information from a database of more than 2,000 patients with broken heart syndrome, the International Takotsubo Registry. Approximately 200 cardiogenic shock developed from these patients.
The researchers found a strikingly high mortality rate for patients with a broken heart syndrome with cardiogenic shock. Almost a quarter (24 percent) of patients with cardiogenic shock died in the hospital, compared with only 2 percent of patients without cardiogenic shock.
Even in patients who survived cardiogenic shock, the higher mortality risk continued for many years. After five years, the mortality rate among patients who had initially survived heart-broken syndrome with cardiogenic shock was about 40 percent compared with only 10 percent for those who did not experience cardiogenic shock. (This mortality rate closed the patients who died within 60 days of their diagnosis.)
The study also found that:
Patients with cardiogenic shock were on average slightly younger, 63 years old, compared with patients who did not develop cardiogenic shock, with a mean age of 67 years.
Patients with cardiogenic shock were more likely to initiate their heart beating syndrome by physical stressors, compared with patients who did not develop cardiogenic shock.
Patients with cardiogenic shock were more likely to have a type of irregular heartbeat called atrial fibrillation; and had higher rates of diabetes and other risk factors for heart disease, such as smoking, than patients who did not develop cardiogenic shock.
The high death rate for patients with broken heart syndrome who develop cardiogenic shock emphasizes the need to recognize signs of cardiogenic shock as early as possible, the researchers said.
Researchers, for example whether a patient with a broken heart syndrome also has diabetes, atrial fibrillation or a physical stress start of their condition, can help doctors identify those who are at risk of developing cardiogenic shock, the researchers said. .
"For such patients, close monitoring can reveal the first signs of cardiogenic shock and allow prompt management," Templin said.
The study also showed that patients with cardiogenic shock were less likely to die in the hospital if they were treated with devices that provided mechanical support to their heart, such as an inflatable device that stimulates blood flow.
"Although these devices should be used with caution, it can be considered as a bridge-to-recovery treatment in patients without contraindications," Templin said.
Future studies are needed to investigate the best treatments for patients with heart defects with cardiogenic shock, both in the short and the long term, according to the researchers.
Originally published on Live Science.