COVID-19 and Heart Disease (Part 7)

Stress induced cardiomyopathy AKA Broken heart syndrome AKA Takosubo syndrome

There is a condition known as stress induced cardiomyopathy.  In this condition the patient can present with chest pain, shortness of breath and have EKG abnormalities that are classic for a heart attack.  Echocardiogram reveals damage to the heart muscle identical to what is seen in the midst of a heart attack. Therefore the patient is rushed to the heart catheterization laboratory and an angiogram is performed expecting to see a blocked coronary artery.  But to every one’s surprise there is no blockage and nothing to fix. As its name suggests, stress induced cardiomyopathy occurs as a result of undue,  unrelenting stress such as when someone loses a loved one or in the setting of severe psychosocial stress (loss of job leading to financial stress, difficult divorce, grieving a loss, etc).

The disease is generally self-limited and patients improve. We do treat the congestive heart failure that accompanies the disease with class of drugs called beta blockers and ACE-Inhibitors. 

Patients with COVID-19 infection have also been presenting with stress induced cardiomyopathy. It is unclear whether the virus causes the disease or all the psychosocial stress associated with living in the era of COVID-19 contributes to stress induced cardiomyopathy. In any case, it is very important that we take care of our mental as well as physical health during the COVID-19 pandemic.