Happy events can trigger a heart condition known as takotsubo syndrome, according to research published in the European Heart Journal.
Takotsubo syndrome (TTS) is known as “broken heart syndrome” and is characterised by a sudden temporary weakening of the heart muscles that causes the left ventricle of the heart to balloon out at the bottom while the neck remains narrow, creating a shape resembling a Japanese octopus trap, from which it gets its name.
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Since this relatively rare condition was first described in 1990, evidence has suggested that it is typically triggered by episodes of severe emotional distress, such as grief, anger or fear, with patients developing chest pains and breathlessness. It can lead to heart attacks and death.
Now, for the first time, researchers have systematically analysed data from the largest group of patients diagnosed with TTS worldwide, and found that some patients have developed the condition after a happy or joyful event; they have named it “happy heart syndrome”.
Dr Christian Templin is the lead investigator and a consultant cardiologist and back in 2011, working together with Dr Jelena Ghadri, a resident cardiologist, established the first International Takotsubo Registry at the University Hospital Zurich in Switzerland. The study used data from the first 1, 750 patients registered from 25 collaborating centers in nine different countries.
Analyzing the data, the researchers found 485 patients who were affected by a definite emotional trigger and 20 (four percent) of the patients had suffered broken heart syndrome after a happy and joyful event, such as a wedding, surprise farewell celebration, birthday party, birth of a grandchild, etc.
The other 465 patients had experienced TTS after stressful and sad events, such as the death of a spouse or family member, attending the resulting funeral, worry about relationship problems, or illness. One obese patient suffered broken heart syndrome after getting stuck in the bath.
Results showed the Takotsubo Syndrome occurred mainly in women, with 95 percent of the patients being female in both the “broken heart syndrome” and “happy heart syndrome” groups. Reportedly the average age of patients suffering from “broken heart syndrome” was 65 years or age, while the average age of those suffering from “happy heart syndrome” was 71. This reportedly confirms that most of the TTS cases occur in post-menopausal women.
Dr Ghadri said, “We have shown that the triggers for TTS can be more varied than previously thought. A TTS patient is no longer the classic “broken-hearted” patient, and the disease can be preceded by positive emotions too.”
Dr Ghadri went on to say clinicians should be aware of this and should consider patients who arrive in emergency rooms with signs of heart attacks, including chest pain and breathlessness, after a happy event could also be suffering from Takotsubo Syndrome and should take this into account.
According to the researchers, “happy heart” patients are more likely to have hearts that ballooned in the mid-ventricle than “broken heart” patients. However, they did say more research is needed to discover whether or not this sheds any light on the mechanisms involved in Takotsubo Syndrome.
Dr Templin said, “We believe that TTS is a classic example of an intertwined feedback mechanism, involving the psychological and/or physical stimuli, the brain and the cardiovascular system. Perhaps both happy and sad life events, while inherently distinct, share final common pathways in the central nervous system output, which ultimately lead to TCS.”
Researchers are now working to further understand the relationship between the brain and the heart, using functional MRI to look at the workings of the parts of the brain involved in the processing of emotions, behavior, reactions, decision-making and memory, including the amygdala and the prefrontal cortex.
