"Broken heart syndrome" may also happen after joyful life events, a new study suggests. Researchers are calling it "happy heart syndrome."
New findings suggest that a small group of patients have takotsubo syndrome triggered by happy life events, report Thomas Stiermaier, MD, of the University Hospital Schleswig-Holstein in Lübeck, Germany, and colleagues.
Notably, these patients were more often male. There was no difference in overall outcomes between people with happy heart and broken heart syndromes, the researchers found.
The results were published online May 4 in JACC: Heart Failure.
Previous reports have shown that takotsubo syndrome can be caused by negative emotional triggers, physical triggers such as heavy physical activity or medical procedures, a combination of emotional and physical triggers, or neither type of trigger, the authors say. Research shows physical triggers are most often linked to bad outcomes.
But more recent information, along with these new findings, suggest joyful events such as weddings, baptisms, the birth of grandchildren, or a birthday party can also be a trigger.
Extreme emotions, both negative and positive, can in rare cases cause takotsubo syndrome, although most patients who experience sorrow or joy in their day-to-day life do not develop the condition, says Jason H. Rogers, MD, a professor of cardiovascular medicine at the University of California, Davis Medical Center in Sacramento.
"One might advise patients to avoid extreme emotions, but having emotions is part of human nature and not something easily controllable," he says. "We tell all patients the same thing: If you feel chest pain or pressure or feel that something is not right with your heart, do not delay in seeking medical attention."
In the new study, the researchers assessed 2,482 patients using the GErman-Italian-Spanish Takotsubo (GEIST) Registry, one of the largest in the world of these cases, to compare triggers and outcomes of those with broken and happy heart syndrome.
Of the 910 patients who had an emotional trigger, there were 37 in the happy heart group and 873 in the broken heart group. The average age was similar between the groups – about 70 years.
Patients with happy heart syndrome more often had abnormal ballooning of the heart and were more often male (18.9% vs 5.0%) than those who had a negative triggering event.
Broken heart and happy heart patients had similar long-term death rates and complications in the hospital.