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Rise in stress cardiomyopathy during COVID-19 pandemic


Cleveland Clinic researchers have found a significant increase in patients experiencing stress cardiomyopathy, also known as broken heart syndrome or Takotsubo cardiomyopathy, during the COVID-19 pandemic.

Stress cardiomyopathy occurs in response to physical or emotional distress and causes dysfunction or failure in the heart muscle.
Patients typically experience symptoms similar to myocardial infarction, such as chest pain and shortness of breath, but usually do not have acutely blocked coronary arteries.
The left ventricle of the heart, however, may show enlargement.
Other symptoms include irregular heartbeat, fainting, low blood pressure and cardiogenic shock.

The COVID-19 pandemic has brought about multiple levels of stress in people’s lives.
People are not only worried about themselves or their families becoming ill, they are dealing with economic and emotional issues, societal problems and potential loneliness and isolation.

The causes of stress cardiomyopathy are not fully understood. However, physicians believe that a person’s reaction to physically or emotionally stressful events causes a release of stress hormones that temporarily reduce the heart’s ability to pump, causing it to contract less efficiently or irregularly instead of in a steady, normal pattern.

For the study, cardiologists looked at 258 patients coming into Cleveland Clinic and Cleveland Clinic Akron General with heart symptoms known as acute coronary syndrome ( ACS ) between March 1 and April 30th and compared them with four control groups of ACS patients prior to the pandemic.

Researchers found a significant increase in patients diagnosed with stress cardiomyopathy, reaching 7.8% compared with pre-pandemic incidence of 1.7%.
Patients with stress cardiomyopathy during the COVID-19 pandemic had a longer length of hospital stay compared with those hospitalized in the pre-pandemic period; however, there was no significant difference in mortality between the groups.
All of the patients diagnosed with stress cardiomyopathy tested negative for COVID-19.

The study was published in JAMA Network Open.

Patients with stress cardiomyopathy generally recover their heart function and recover in a matter of days or weeks, although the condition can occasionally cause major adverse cardiac and cerebrovascular events and rarely can be fatal.
Stress cardiomyopathy is typically treated with heart medications to lower blood pressure and slow the heart rate.
Other medications may be prescribed to help manage stress. ( Xagena )

Source: Cleveland Clinic, 2020

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