Pandemic stressors give rise to 'broken heart' syndrome

Researchers believe anxiety caused by the COVID-19 crisis likely contributed to more cases of stress cardiomyopathy in patients with acute coronary syndrome (ACS) who underwent coronary arteriography.

Researchers believe anxiety caused by the COVID-19 crisis likely contributed to more cases of stress cardiomyopathy in patients with acute coronary syndrome (ACS) who underwent coronary arteriography. The team retrospectively analyzed medical data covering four periods in 2018, 2019, and 2020 from two hospitals within the Cleveland Clinic health system. They calculated that incidence rates for the condition, also known as Takotsubo syndrome, hovered between 1.5% and 1.8% prior to the public health crisis but rose to 7.8% in March and April of this year. While patients with stress cardiomyopathy during the pandemic tended to remain in the hospital for longer periods of time, diagnosis during the pandemic was not associated with greater mortality risk or higher probability of hospital readmission within 30 days. "The psychological, social, and economic distress accompanying the pandemic, rather than direct viral involvement and sequelae of the infection, are more likely factors associated with the increase in stress cardiomyopathy cases," the investigators reported in JAMA Network Open. "This was further supported by negative COVID-19 testing results in all patients diagnosed with stress cardiomyopathy in the study group." Still, the team has not ruled out a correlation between COVID-19 and Takotsubo-like cardiomyopathy. "The mechanism behind this type of myocardial injury in patients with COVID-19 remains to be elucidated," they wrote.