Broken-heart syndrome mimics attack

DEAR DR. GOTT: I have been diagnosed with Takotsubo cardiomyopathy. What can you tell me about this condition? What might I expect in the future? My doctor has put me on two medicines: Coumadin and Coreg.

DEAR READER: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, broken-heart syndrome, apical ballooning syndrome and stress-induced cardiomyopathy, is a fairly complex condition.

It mimics a heart attack or acute coronary syndrome. It is frequently brought on by acute medical illness or intense physical or emotional stress (such as that caused by the death of a loved one, hence the name broken-heart syndrome). It is more common in women than in men.

It is not known how prevalent this condition is because little is known about it. It was initially thought to be uncommon, but recent studies suggest it may account for up to 2 percent acute coronary syndrome events.

It is a transient disorder, meaning that it comes and goes. It is managed primarily with supportive therapy such as stress reduction.

Treatment during the acute phase of the attack usually lasts one to four weeks and consists of ACE inhibitors, beta blockers, diuretics and/or aspirin. Because Takotsubo can recur, long-term treatment with beta- or alpha- and beta-blockers may be continued.

Speak with your cardiologist about any further questions. He or she is your best resource for information. It may also be in your best interest to be under the care of a cardiologist familiar with the disorder or to have your doctor initiate regular communication with such a physician. This will provide you with any new information or treatment options.

I am sending you a copy of my health report "Coronary Artery Disease.” Other readers who would like a copy should send a self-addressed, stamped, business-size envelope and a check or money order for $2 to Newsletter, P.

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