Takotsubo Cardiomyopathy: Scientists Reveal How "Broken Heart Syndrome" Is Linked to Emotional Trauma

"We are convinced we will find the answers of the underlying mechanism primarily in the brain."

The connection between emotions and health is becoming more clear, but nowhere is it more evident than in patients with broken heart syndrome. This heart condition, brought on by intense emotional trauma, is a famous example of the toll that grief can take on the body. Scientists in Switzerland, however, believe that the beginnings of a broken heart can be traced back to the brain.

Patients who suffer from broken heart syndrome, also called takotsubo cardiomyopathy (TTS), describe symptoms similar to those of a heart attack — shortness of breath, or sudden chest pain. The left ventricle of the heart tends to swell, and generally, the heart continues to struggle as it weakly pumps blood through the body. Strangely, these symptoms tend to occur after intense suffering or trauma, suggesting that there is a connection between the brain and the heart that underlies the disease. In a paper published in European Heart Journal, Dr. Jelena Ghadri and Christian Templin, Ph.D., both at University Hospital Zurich’s Cardiovascular Center, believe that they’ve found the center of that heart-brain connection.

“Takotsubo cardiomyopathy is in fact a brain-heart-syndrome,” Ghadri tells Inverse. ”One major problem in TTS research is that cardiologists usually focus only the heart. However, TTS is a multifacated disorder that is much more than the ‘broken heart syndrome’ and clearly involves interactions between the brain and the heart, which are not very well understood.”

Patients with broken heart syndrome usually develop heart problems in response to traumatic life events. 

Unsplash / Jordan Bauer

After examining brain scans collected from 15 people with confirmed cases of broken heart syndrome and 39 healthy participants, Ghadri and Templin noticed that patients with the condition had less connectivity between certain networks in their brains. In particular, broken heart syndrome patients had decreased connectivity in their limbic systems, the network that helps process emotion and the network that controls the autonomic nervous system, which controls autonomous bodily functions like breathing and heartbeat.

"We are convinced we will find the answers of the underlying mechanism primarily in the brain.

Templin and Ghadri were particularly interested in several “key nodes” — brain structures within these networks that they believe hold the secrets to the “brain-heart connection.” They narrowed in on several structures, including the amygdala, hippocampus ,and cingulate gyrus. Alterations to these structures, adds Templin, may change how stressful events manifest in the brain, which could lead to problems with the heart.

“Importantly, the regions we’ve identified as communicating less with one another in TTS patients are the same brain regions that are thought to control our response to stress,” Templin said. “Therefore, this decrease in communication could negatively affect the way patients respond to stress and make them more susceptible to developing TTS.”

Ghadri adds that this represents a new way of looking at broken heart syndrome. Maybe, she says, it’s a condition that begins with problems in the brain but manifests by altering the function and even shape of the heart. “We know that an emotional event triggers TTS and emotions are processed in the brain; therefore it is conceivable that the TTS orgininates in the brain with top-down-influences on the heart,” she explains.

When it comes to helping identify the disease before it can strike, she believes that the brain is where she’ll find the true warning signs.

“One major question for the future,” she says, “is ‘Who is at risk, and why?’ And can we prevent and treat TTS? We are convinced we will find the answers of the underlying mechanism primarily in the brain”

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