Diagnosis

If your doctor suspects you have broken heart syndrome, he or she will use these exams and tests to make a diagnosis:

  • Personal history and physical exam. In addition to a standard physical exam, your doctor will want to know about your medical history, especially whether you've ever had heart disease symptoms. People who have broken heart syndrome usually don't have any heart disease symptoms before they're diagnosed with broken heart syndrome. Also, your doctor will want to know if you've experienced any major stresses recently, such as the death of a loved one.
  • Electrocardiogram (ECG). In this noninvasive test, a technician will place wires on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor detect irregularities in your heart's rhythm and structure.
  • Echocardiogram. Your doctor may also order an echocardiogram to see if your heart is enlarged or has an abnormal shape, a sign of broken heart syndrome. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function.

    Ultrasound waves are transmitted, and their echoes are recorded with a device called a transducer that's held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.

  • Blood tests. Most people who have broken heart syndrome have an increased amount of certain enzymes in their blood. Your doctor may order blood tests to check for these enzymes to help diagnose broken heart syndrome.
  • Chest X-ray. Your doctor will likely order a chest X-ray of your chest to see if your heart is enlarged or has the shape that's typical of broken heart syndrome, or to see if there are any problems in your lungs that could be causing your symptoms.
  • Cardiac magnetic resonance imaging (MRI). For this test, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field produces detailed pictures to help your doctor evaluate your heart.
  • Coronary angiogram. During a coronary angiogram, a type of dye that's visible by X-ray machine is injected into the blood vessels of your heart. Then, an X-ray machine rapidly takes a series of images (angiograms) that give your doctor a detailed look at the inside of your blood vessels.

    Because broken heart syndrome often mimics the signs and symptoms of a heart attack, a coronary angiogram may be done quickly to rule out a heart attack. People with broken heart syndrome often don't have any blockages in the blood vessels, while people who've had a heart attack usually have a blockage that is visible on an angiogram.

    Once it's clear you're not having a heart attack, your doctor will check to see if your signs and symptoms were caused by broken heart syndrome.

Nov. 05, 2016
References
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  7. Reeder GS, et al. Clinical manifestations and diagnosis of stress (takotsubo) cardiomyopathy. http://www.uptodate.com/home. Accessed Aug. 23, 2016.
  8. Izumi Y. Drug-induced Takotsubo cardiomyopathy. Heart Failure Clinics. 2013;9:225.
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