As a young resident in a stroke unit, I was once taking care of an 82-year-old patient. She had come to the emergency room because a few hours earlier she had suddenly noticed speech disorders and paralysis on one side – both typical signs of a stroke. We gave her medicines that dissolve blood clots and her symptoms slowly improved. But then I got a call from our laboratory: they had found high levels of the heart enzyme troponin in her blood. Since this could indicate a heart attack, I took a look at the woman’s EKG. I noticed changes that can occur with a circulatory disorder of the heart muscle. An additional blood test done in the meantime showed that her troponin levels had continued to rise.
The patient’s condition also deteriorated. We did an ultrasound of her heart; she revealed that the organ’s pumping capacity had measurably decreased and parts of the heart wall were no longer moving normally. We therefore decided to carry out an additional cardiac catheter examination. In this minimally invasive treatment, a tube with measuring devices is inserted into an artery and guided to the heart. Surprisingly, our patient’s coronary vessels looked completely healthy here. A classic heart attack was thus ruled out. So what was going on in the woman’s heart? We noticed that the apex of the heart in particular was enlarged like a balloon and that mobility was restricted. The diagnosis was clear: the patient had Takotsubo Syndrome (TTS). We therefore gave her other medicines to improve her heart failure. It took three days for her heart to pump steadily again. In a repeat ultrasound scan a week later, the organ looked perfectly normal.
Experts around Hikaru Sato from Hiroshima City Hospital first described the TTS in 1990. The word “Takotsubo” comes from the Japanese and describes a clay jug (“tsubo”) with a wide base and a narrow neck. The vessel is used to catch squid (»tako«). The diseased heart, with its balloon-like enlarged tip, reminded the first describer of the shape of this jug…