Takotsubo syndrome (broken heart syndrome): symptoms, tests and recovery

The name comes from a Japanese octopus-trap pot. The BHF explains that in takotsubo syndrome the left ventricle, the heart's main pumping chamber, narrows towards the top and becomes larger and rounder at the bottom, resembling that pot. The muscle weakens and its pumping action loses strength.

The condition goes by several names, including broken heart syndrome, takotsubo cardiomyopathy, acute stress-induced cardiomyopathy and apical ballooning syndrome. The NHS cardiomyopathy page uses the terms Takotsubo cardiomyopathy and acute stress cardiomyopathy and notes it is more common in women.

Importantly, the BHF says the condition is usually temporary, lasting a few days or weeks, and unlike some other cardiomyopathies, such as hypertrophic cardiomyopathy, it is not inherited. It states that it affects up to 5,000 people in the UK every year. The word cardiomyopathy can sound alarming, but the course of takotsubo is usually very different from the long-term inherited forms.

The BHF reports that people say 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 and shortness of breath. Less common ones include palpitations, feeling faint or lightheaded, and feeling or being sick.

There is no reliable way to tell the difference at home, and the two conditions can look similar on first tests. The BHF's advice is to call 999 immediately if you think you are having a heart attack. Doctors will check for a blocked artery first, because a heart attack needs rapid treatment. Do not delay the call because you suspect a stress reaction.

The BHF says no one knows the exact cause. Its experts suggest that a rush of overwhelming stress hormones such as cortisol and adrenaline puts sudden stress on the heart, causing temporary damage. For some people an event such as a death, illness, surgery, mental trauma or financial stress can trigger it. It adds that researchers are still trying to understand why.

The BHF names women, people over 50 and people with mental health conditions such as anxiety or depression as more likely to be affected. The trigger need not be negative or emotional; the BHF refers to overwhelming physical or emotional stress, and some people have no clear trigger at all.

• If you or someone you know has been through emotional or physical stress and needs help, the BHF suggests contacting your GP.

• Organisations such as Citizens Advice can help with practical stresses such as finances, disputes and family issues.

The BHF explains that takotsubo is usually diagnosed after you come to hospital with heart attack symptoms and are sent for tests. These help show what is wrong with your heart and rule out a blocked artery.

According to the BHF, takotsubo may be diagnosed if tests rule out a heart attack, the heart muscle looks weakened or is not pumping blood properly, and the left ventricle has changed shape. Your doctor may also ask about your medical history and any recent physical or emotional stress.

Because the story matters, it helps to tell the team about recent bereavement, illness, surgery or crises, even if they seem unrelated to the chest pain.

The BHF says you might recover within a couple of months once your body begins to cope better with the stress, and that the doctor may use medicines to manage symptoms and help the heart recover: diuretics to reduce fluid build-up if you are breathless, beta blockers and ACE inhibitors or ARBs to take pressure off the heart, and blood thinners if you are at high risk of blood clots or an arrhythmia such as atrial fibrillation. There is not one treatment for everyone, but in most cases the condition improves and gets better. Usually people stay in hospital while they begin to recover, and make a full recovery within weeks, with cardiologist check-ups and repeat echocardiograms to check how the heart is working.

In rarer cases the heart might permanently change shape and symptoms may not completely go away. The BHF says about 1 in 10 people who have had takotsubo syndrome develop it again, and that to prevent another episode many healthcare professionals recommend long-term beta blockers or similar medicines, which block the harmful effects of too many stress hormones. It adds that more research is needed on which treatments suit long-term management.

The BHF encourages staying active (it mentions yoga or a walk in nature), eating healthily, talking to friends, family or support groups, and considering a counsellor or clinical psychologist, with NHS talking therapies available if you are registered with a GP.

The first episode is handled through the emergency pathway, usually with ambulance transfer and admission under cardiology, as it is initially managed like a heart attack. That is NHS territory, and delaying to seek private care risks missing time-critical treatment.

Afterwards, follow-up is usually with an NHS cardiologist with repeat echocardiography. Some people pay privately for additional cardiac imaging or a second opinion on long-term beta blockers, and others seek private counselling. Whichever route you choose, make sure your GP and cardiologist are informed about any medicines or tests.