Broken Heart Syndrome Linked With Cancer

Breast Cancer, Gastrointestinal Tumors Most Common Types

One in six people with broken heart syndrome had cancer and were less likely to survive for five years after it occurred, according to new research in the Journal of the American Heart Association.

Broken heart syndrome occurs when the heart’s main pumping chamber temporarily enlarges and fails to pump properly. (The syndrome, also known as takotsubo cardiomyopathy, was first reported in Japan in 1990. Tako-tsubo means “fishing pot for trapping octopus” in Japanese, and the left ventricle of the heart in patients diagnosed with the syndrome resembles that shape.)

Patients can feel like they are having a heart attack, with accompanying chest pain and shortness of breath, but there is no damage to the heart muscle or any blockage in the coronary arteries. Emotional or physical stress can trigger broken heart syndrome, but this international study of patients from 26 centers provides the strongest association yet between the syndrome and cancer.

Overall survival in patients with broken heart syndrome could be improved if the patients are screened for cancer, according to senior study author Christian Templin, MD, PhD, director of Interventional Cardiology at the University Heart Center Zurich in Switzerland.

In addition, the researchers hope that the study will alert oncologists and hematologists to the possibility of broken heart syndrome in patients undergoing cancer diagnosis or treatment who experience chest pain, shortness of breath, or abnormalities on their electrocardiogram.

Of 1,604 patients with broken heart syndrome in the International Takotsubo Registry, 267 (average age, 69.5 years; 87.6% female) had cancer. The most frequent type was breast cancer, followed by tumors affecting the gastrointestinal system, respiratory tract, internal sex organs, skin, and other areas.

Compared to patients without cancer, researchers found that those with cancer were:

  • Less likely to have had an emotional trigger for the syndrome, 18.0% vs. 30.3%.
  • More likely to have experienced a physical trigger (e.g., a medical intervention or physical trauma) before the syndrome, 47.9% vs. 34.2%.
  • Equally likely to survive for 30 days after the syndrome began, but more likely to die or require intensive heart and respiratory support while in the hospital.
  • More likely to die within five years after the syndrome began.

The researchers say the study was too small to analyze whether the worse prognosis in patients with broken heart syndrome and cancer is caused by a specific type or stage of cancer, or by the cancer treatments received.

Source: American Heart Association, July 17, 2019