Todd Hurst, MD
About 15 years ago, I was called to the ER to see a 49-year-old woman who was having a heart attack.
The typical signs of heart attack were there: the sudden onset of chest pain, an abnormal ECG, and a blood test result that was consistent with heart muscle damage.
But this patient didn’t fit the typical picture of someone at risk for a heart attack. She was very active, ate well, and was at a healthy weight. Her cholesterol, blood sugar, and blood pressure numbers were outstanding, and she had no family history of heart disease.
The other unusual thing: Her symptoms started soon after she heard about the tragic death of a loved one.
After discussing the options, we decided to perform a heart catheterization to evaluate her heart arteries. The results were surprising. First, her arteries looked completely normal. But the bigger surprise was that, despite her healthy arteries, the function of her heart was severely decreased, with about 2/3 of her heart not squeezing.
My colleagues and I were perplexed. Though we were a world famous academic medical group, with many decades of experience, none of us had seen anything like this before. How did this healthy young woman have so much damage to her heart with completely normal arteries? We bounced around several theories, and decided the best course was to place her on medications known to benefit those with weak heart muscles.
The next surprise came on follow-up a few months later. An echocardiogram showed that her heart was completely normal! She felt great and was back to all of her usual activity. Although I was very glad she was better, I still didn’t have an explanation for what happened to her.
After that first patient, I learned that other cardiologists around the country were reporting the same thing, and it was eventually recognized that similar patients were described in Japan in the 1990’s. They called this syndrome “takotsubo” (the Japanese word for octopus pot) because the heart looked like an octopus pot during the episode. In America, it’s known as “broken heart syndrome.”