Takotsubo syndrome

What is takotsubo syndrome?

‘Takotsubo’ is a word taken from the name of a pot used in Japan to catch octopuses. With takotsubo syndrome, the left ventricle (heart chamber) narrows towards the top, looking larger and rounder at the bottom like a takotsubo pot. 

Takotsubo syndrome causes your heart's main pumping chamber (the left ventricle) to change shape and get larger. The heart muscle becomes weaker and its pumping action loses strength. 

You might hear takotsubo syndrome also being called:

• broken heart syndrome
• takotsubo cardiomyopathy
• acute stress-induced cardiomyopathy
• apical ballooning syndrome
• takotsubo.

The condition is usually temporary and happens to some people when their body is coping with overwhelming physical or emotional stress. Many know it as broken heart syndrome because of its connection to grief. The condition can last a few days or weeks. With medicine, most people completely recover. 

Unlike some other cardiomyopathies, like hypertrophic cardiomyopathy (HCM), it's not an inherited heart condition. 

Who is most at risk of takotsubo syndrome?

Takotsubo syndrome is more common in: 

• women
• people over 50 
• people with mental health conditions like anxiety or depression.  

It’s not an inherited condition (passed down through families) and affects up to 5000 people in the UK every year. 

What are the symptoms of takotsubo syndrome?

People have told us takotsubo syndrome can feel a little like a heart attack.

The most common symptoms are: 

• sudden, intense chest pain 
• pressure or heaviness on the chest 
• shortness of breath. 

If you think you're having a heart attack, call 999 immediately. 

Other less common symptoms are: 

• palpitations (a fluttering, pounding, a thud or movement in your chest or neck)
• feeling faint or lightheaded
• feeling or being sick.

What causes takotsubo syndrome?

No one knows the exact cause of takotsubo syndrome. Our experts suggest that a rush of overwhelming stress hormones, like cortisol and adrenaline put sudden stress on the heart, causing temporary damage.  
 
For some people, an event like death, illness, surgery, mental trauma or financial stress can trigger takotsubo. Our researchers are still trying to understand the reason for this.

If you or someone you know has gone through emotional or physical stress and you need help, contact your GP for advice. There are also organisations like citizens advice that can offer support and advice on things like finances, court disputes, family issues and much more. 

How is takotsubo syndrome diagnosed?

Takotsubo is usually diagnosed after you’ve come to hospital with heart attack symptoms.  

You’ll be sent for tests to see what the problem with your heart is. These may include:  

• blood tests –to check for chemicals in your blood caused by heart damage 
• a coronary angiogram – to see if there’s a blockage in your heart’s arteries 
• an ECG – to check your heart rate and rhythm 
• an echocardiogram – to see if the shape of your heart has changed 
• an MRI scan – for more detailed images of your heart.  

You may be diagnosed with takotsubo syndrome if: 

• tests rule out a heart attack  
• your heart muscle looks weakened or is not pumping blood as it should
• your left ventricle has changed shape. 

Your doctor might also ask you about your medical history and if you’ve been under any physical or emotional stress recently.  

How is takotsubo syndrome treated?

If you’ve been diagnosed with takotsubo syndrome, you might recover within a couple of months, after your body starts to cope better with any stress you've been going through.  
 
To manage your symptoms and help your heart recover, your doctor might give you any of the following medicines:  

• diuretics to reduce fluid build-up and help if you've been breathless
• beta blockers and ACE inhibitors/ARBs to take the pressure off your heart and help it work better
• blood thinning medicine if you are at high risk of developing blood clots or an arrhythmia such as atrial fibrillation. 

Recovering from takotsubo syndrome

Usually, people with takotsubo syndrome will stay in hospital while they begin to recover and usually make a full recovery within weeks. 
 
After you’ve been diagnosed, you’ll attend check- ups with a cardiologist where you can ask them about medicines and your plan for recovery. During this time, you’ll also be sent for echocardiograms to check how your heart is working  

You should also try to: 

• Get active – yoga is very effective for stress or try a walk to get out in nature. 
• Eat healthily – we tend to grab quick but less nutritious food during stressful times. Try to snack on foods that can support you and your heart during this time. 
• Talk to others – talk to friends and family or try support groups for a range of topics like grief or trauma.  

As takotsubo syndrome is usually caused by stress or trauma, you might find it helpful to talk to a counsellor or clinical psychologist during and after your recovery. If you're registered with a GP, you can access talking therapy through the NHS.

We also offer information about topics like counselling and depression on our emotional support hub. 

Is there a cure for takotsubo syndrome? 

There is not one treatment used for everyone with takotsubo syndrome, but in most cases it does improve and get better. In rarer cases your heart might permanently change shape and symptoms might not completely go away.  

About 1 in 10 people who’ve had takotsubo syndrome develop it again after they’ve recovered.  

To prevent another episode of takotsubo, many healthcare professionals recommend long-term treatment with beta blockers or similar medicines. These medicines block the harmful effects of too many stress hormones on the heart. 

More research is needed to understand the complex reasons why takotsubo syndrome happens and which treatments can be used to manage it for the long-term.  

• Read Dawn's experience of recovering from takotsubo.
• Read our news piece on current treatments for takotsubo.  
• Listen to our live and ticking discussion about takotsubo.  

Heart Helpline & other support:

• Call our Heart Helpline.
• Speak to others with heart conditions by joining a support group or online community.
• Sign up to our Heart Matters magazine and online information packed with health and lifestyle advice.