“The condition’s name comes from the fact that, when affected by it, the left ventricle resembles a ‘takotsubo’, a pot used to trap octopi in Japan” Illustration by Alisa Santikarn for Varsity

From Tristan and Isolde to Yoshihide in Hell Screen to Madame Butterfly, the broken heart is steeped in global literature and, in many cases, in our own lives, whether from romantic desolation, familial loss or platonic dissolution.

Yet, can humans really die from heartbreak? Or, is it simply an overly- used, melodramatic trope employed to heighten our emotional connection with literary characters? The evidence is limited, but the identification of takotsubo syndrome in Japan in the 1990s – and the condition’s global prevalence – supports the former argument.

Takotsubo cardiomyopathy, or ‘broken-heart syndrome,’ is a temporary, sudden weakening of the heart’s left ventricle – which pumps blood to the rest of the body via the systemic circulation – usually following severe emotional or physical stress.

The condition was named takotsubo syndrome because the left ventricle, when afflicted with the condition, looks like a tako tsubo, a pot used to trap octopi in Japan.

Perhaps most interestingly, the disorder is non-ischaemic, meaning – unlike in coronary artery disease – it is not caused by an artery obstruction leading to a heart attack.
In fact, the two conditions are almost indistinguishable, save for this difference with the symptoms of takotsubo cardiomyopathy mirroring those of a heart attack, including chest pain, shortness of breath and similar ECG abnormalities.

This is thought to be a result of a sudden surge in catecholamine release (such as noradrenaline and adrenaline) that leads to arteries tightening, blood pressure rising and increasing stress on the heart. This leads to problems with the heart carrying out normal contractions. However, relatively little is known of the direct causes or mechanisms.
Interestingly, 90% of reported cases are in women (although, in Japan, the condition is more prevalent in men).

Additionally, 28.5% of patients had no evident trigger and while physical triggers were the supposed cause for 36% of reported cases – compared to a lesser 27.7% by emotional triggers – half of patients with the condition had an acute, former, or chronic neurologic or psychiatric disorder. Overall, death is rare, although heart failure is common, along with other cardiac complications. 

Whilst the prognosis may not be as bad as it was for Lady Montague in Romeo and Juliet, takotsubo syndrome perhaps indicates the strength of the communication between the brain and the heart, and the significant ways in which our psychological and emotional state can influence our physiology.

The understanding we have on takotsubo syndrome is, frankly, rather poor. That being said, perhaps what we can gather from this recently recognised condition is the richness and strength of human relationships, whether romantic, platonic or familial, and the significant influence of these connections on our survival and our lives.

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