Scientists have learned to distinguish the syndrome of a broken heart from a heart attack by blood analysis

Broken heart syndrome can manifest itself in much the same way as a myocardial infarction: a person experiences severe chest pain, shortness of breath, and changes in the electrocardiogram. Until now, patients often had to undergo emergency cardiac catheterization to accurately distinguish between these conditions. Now, an international team of researchers has developed a diagnostic model that helps to suspect Takotsubo syndrome even before conducting an invasive examination. About what the broken heart syndrome is and how the new diagnostic method works is in the Izvestia article.

What is Broken Heart Syndrome?

The disease occurs not only after severe emotional experiences. It accounts for about 2% of all cases when a patient is hospitalized with suspected myocardial infarction, and among women with acute coronary syndrome it is detected in about one out of 10 cases. The syndrome most often develops in women after menopause.

In most cases, the disorder is temporary, but in the acute phase it can be accompanied by serious complications. That is why patients with suspected Takotsubo syndrome need to be examined as quickly as people with suspected heart attacks.

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Why the heart can "break" from severe stress

The exact mechanism of development of Takotsubo syndrome is still a subject of research. It is known that the disease often occurs after a severe emotional shock, such as the loss of a loved one, a serious conflict or other stressful events. However, it can also be triggered by physical exertion on the body, including serious illnesses, surgeries or injuries.

The authors of the new study note that the so–called "brain—heart" axis, the system through which the nervous system regulates the functioning of the cardiovascular system, may play an important role. That is why severe stress can temporarily change the functioning of the heart muscle, even without blockage of blood vessels.

The researchers also found biomarkers related to the regulation of stress reactions, the functioning of the autonomic nervous system and vascular tone. In their opinion, this confirms that Takotsubo syndrome develops by biological mechanisms different from classical myocardial infarction. The results of the work are published in the journal Science Daily.

Why is it difficult to distinguish it from a heart attack?

The main problem is that in the first hours, the conditions of a heart attack and broken heart syndrome look almost the same. Patients experience severe chest pain, shortness of breath, changes in the electrocardiogram and increased levels of cardiac biomarkers — these are the signs that are characteristic of a heart attack.

At the same time, the causes of diseases vary. If a heart attack occurs due to a blockage of the coronary artery, then in Takotsubo syndrome, significant obstacles to blood flow are usually not found. However, it is almost impossible to understand this only by the symptoms or the usual tests.

Therefore, today, most patients with suspected acute coronary syndrome undergo coronary angiography, a study in which a catheter is inserted through a vessel to the heart and the condition of the coronary arteries is assessed. Only then can doctors definitively determine whether it is a heart attack or a broken heart syndrome.

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How did scientists find a way to distinguish conditions based on a blood test?

An international group of researchers, together with specialists from the universities of Zurich and Greifswald, has developed a BioTAK diagnostic model. To do this, the scientists used artificial intelligence methods to determine the most informative combination of blood biomarkers, which makes it possible to distinguish Takotsubo syndrome from a heart attack.

The final model includes several blood counts reflecting various processes in the cardiovascular system, as well as the biological sex of the patient. According to the researchers, some of these biomarkers simultaneously help to better understand the mechanisms of the disease itself.

After creating the algorithm, the scientists tested it on an independent group of almost 1.8 thousand patients admitted with suspected acute coronary syndrome.

How accurate was the new method?

During the test, the model was able to correctly classify almost 90% of patients even before the coronary angiography. To do this, the researchers used predefined thresholds to assess the likelihood of Takotsubo syndrome based on a combination of blood biomarkers and the patient's gender.

The authors emphasize that the new algorithm does not replace cardiac catheterization in cases where it is necessary for medical reasons. However, it can become an additional tool that will help doctors determine the most likely diagnosis faster, plan further examinations more efficiently, and in some cases avoid unnecessary invasive procedures.