Though not having a heart attack, patients with “broken heart” syndrome still face considerable risk of hospital readmission and in-hospital death. This is the main finding of a study led by researchers at NYU School of Medicine and published online October 2 in the European Heart Journal—Quality of Care and Clinical Outcomes.

“Broken heart” syndrome—also called Takotsubo syndrome—and heart attack have common symptoms, including chest pain and difficulty breathing, which can make recognition of Takotsubo syndrome challenging for physicians. Typically brought on by stressful events, Takotsubo syndrome involves a sudden weakening of the heart muscle not caused by major arterial blockage, whereas heart attack results from severe blockage of an artery.

Based on analyses of 61,412 men and women with the syndrome, the research team found that 12% of such patients were hospitalized within 30 days of discharge, compared to 17% of patients who had a heart attack (acute myocardial infarction, or AMI). The research team also found that, among patients readmitted to hospital within 30 days, nearly 4% of Takotsubo syndrome patients and 7% of patients with AMI died during their stay.

“Our findings show that Takotsubo syndrome still presents considerable risk to patients after they’re initially discharged from the hospital,” says Harmony Reynolds, MD, an associate professor of medicine in the Leon H. Charney Division of Cardiology at NYU Langone Health and senior investigator of the study. “Even though the heart muscle recovers full function in survivors, there are lasting effects on the body. Physicians should monitor Takotsubo patients carefully.”

Although commonly presumed to be temporary, Takotsubo syndrome often causes patients to experience other cardiac events, say the authors. As part of their study, researchers found that the most common cause for patient readmission was heart failure, a buildup of fluid in the lungs and the body due to loss of the heart’s ability to pump blood properly—11% of Takotsubo syndrome patients and 13% of AMI patients had this complication.

“Takotsubo patients should be given a detailed discharge plan and counseled on potential reasons to revisit their doctor, such as difficulty breathing or swelling of the legs,” says study co-lead investigator and interventional cardiologist Nathaniel Smilowitz, MD, an assistant professor of medicine at NYU Langone. “These are very sick patients who need close follow-up.”

—Newswise