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People with a rare condition called "broken heart syndrome" need immediate medical attention, but often recover quickly. But the problem can be particularly deadly if these patients also develop a complication in which their heart can not pump enough blood to the body, a new study reveals.
In addition, the risk of death of patients with broken heart syndrome and presenting with this complication – called cardiogenic shock – remains high not only during their stay in the hospital, but also for years.
"Beyond the higher mortality in the short term, this analysis revealed for the first time that people with broken heart syndrome complicated with cardiogenic shock were at risk of death years later, highlighting the The importance of careful long-term follow-up, particularly in this patient Dr. Christian Templin, lead author of the study and Head of Acute Cardiac Care at the University Heart Center at the University Hospital Zurich in Switzerland, said in a statement.
The findings will be presented at the meeting of the Scientific Sessions of the American Heart Association in Chicago and will simultaneously be published in the journal Circulation. [9 New Ways to Keep Your Heart Healthy]
Broken heart syndrome, also known as takotsubo syndrome, is a condition in which the main pumping chamber of the heart, the left ventricle, enlarges and weakens temporarily so as not to pump properly. (The syndrome takes its name from the strange shape the heart takes as the ventricle grows, and looks like a "takotsubo", a Japanese peach pot used to trap octopus.) This condition is often caused by emotional stress, such as a loved one or the loss of a job, according to the Mayo Clinic. But it can also be triggered by physical stress, such as an asthma attack or major surgery.
Symptoms of broken heart syndrome may resemble those of a heart attack and include chest pain and shortness of breath. But unlike a heart attack, the heart arteries are unobstructed and patients recover completely in a matter of days or weeks, according to the Mayo Clinic.
However, about 1 in 10 patients with broken heart syndrome experience cardiogenic shock, a life-threatening complication in which the heart can not suddenly pump enough blood to meet the needs of the body.
A broken heart complicated
In this new study, researchers sought to better understand the fate of patients when they develop a broken heart syndrome under cardiogenic shock and what treatments might help these patients.
The researchers analyzed information from a database of more than 2,000 patients with broken heart syndrome, called the Takotsubo International Registry. Of these patients, about 200 developed cardiogenic shock.
The researchers found a surprisingly high death rate in patients with heart-broken syndrome who had cardiogenic shock. At the hospital, nearly one quarter (24%) of patients with cardiogenic shock died, compared to only 2% of patients without cardiogenic shock.
Even in patients who survived cardiogenic shock, the higher risk of death persisted for years. After five years, the mortality rate of patients who initially survived the broken heart syndrome under cardiogenic shock was about 40%, compared to only 10% in patients who did not experience cardiogenic shock. (This mortality rate excludes patients who die within 60 days of diagnosis.)
The study also revealed that:
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Patients with cardiogenic shock tended to be slightly younger, at age 63 on average, than patients without cardiogenic shock, whose mean age was 67 years.
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Patients with cardiogenic shock were more likely than patients who did not develop cardiogenic shock to contract their broken heart syndrome due to physical stressors.
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Patients with cardiogenic shock were more likely to have a type of irregular heart rhythm called atrial fibrillation; and had rates of diabetes and other risk factors for heart disease, such as smoking, that were higher than patients who did not develop cardiogenic shock.
The high rate of death in patients with broken heart syndrome who develop cardiogenic shock emphasizes the need to identify the signs of cardiogenic shock as early as possible, the researchers said.
Examining factors such as diabetes, atrial fibrillation, or a physical stressor provoked by cardiac stress in patients with broken heart syndrome could help doctors identify patients at risk of cardiogenic shock, the researchers said .
"For these patients, close monitoring could reveal the early signs of cardiogenic shock and allow for early management," Templin said.
The study also revealed that patients with cardiogenic shock were less likely to die in the hospital if they were treated with devices providing mechanical support to the heart, such as a device inflatable that helps stimulate blood flow.
"While these devices should be used with caution, they could be considered a gateway to healing in patients without contraindications," Templin said.
Future studies are needed to examine the best short- and long-term treatments for patients with broken heart syndrome and cardiogenic shock, the researchers said.
Originally published on Science live.
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