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Takotsubo cardiomyopathy, also known as "broken-heart syndrome" was already a mystery, but new research shows that it can be caused by some very unexpected events, as well.

"They died of a broken heart," people will often say after an elderly person passes away shortly after their partner. As strange as it sounds, this can indeed happen. Takotsubo cardiomyopathy, a condition in which the left ventricle of the heart changes shape, is usually temporary and without long-term effects. However, the condition can be fatal. Though the exact cause of Takotsubo cardiomyopathy has not scientifically been confirmed yet, it was known that around three quarters of those struck by this condition experience severe stress — emotional or physical — prior to developing symptoms. 

No wonder, then, that Takotsubo cardiomyopathy was also dubbed "broken-heart syndrome". The thought that severe sadness, stress or trauma can induce a cardiac-related death is scary enough, but a University Hospital Zurich research team reveals that Takotsubo cardiomyopathy can also be the result of brief moments of extreme happiness. 

A previous Canadian case study had already shown that one woman experienced Takotsubo cardiomyopathy after a happy event, but the Swiss study team reveals that this case was part of a pattern, rather than being an isolated event. After analyzing the medical records of 1,750 patients who suffered Takotsubo cardiomyopathy, using the  International Takotsubo Registry, the team discovered that around one in 20 patients experienced unusually happy moments before they started having symptoms. Those events included the birth of a grandchild, a birthday party, a son's wedding, being reunited with a friend after 50 years, winning the jackpot, the rugby team you support winning, and perhaps most shockingly even receiving the all-clear for another medical condition following a CT scan!

Out of the patients the team examined, Takotsubo cardiomyopathy was shown to have been triggered by intense emotion in 485 cases. Ninety-four percent of those were still found to be rooted in negative emotions, and most emotion-related cases of Takotsubo cardiomyopathy occurred in post-menopausal women.

Interestingly enough, the team additionally found that patients whose Takotsubo cardiomyopathy was triggered by a happy event were more likely to undergo a mid-ventricle than a left-ventricle expansion. 

Research team member Dr Jelena Ghadri noted that "the triggers for takotsubo syndrome can be more varied than previously thought", adding that "a Takotsubo syndrome patient is no longer the classic 'broken-hearted' patient, and the disease can be preceded by positive emotions too". 

Dr Ghadri added: 

"Clinicians should be aware of this and also consider that patients who arrive in the emergency department with signs of heart attacks, such as chest pain and breathlessness, but after a happy event or emotion, could be suffering from Takotsubo syndrome just as much as a similar patient presenting after a negative emotional event."

While the thought that the very life-changing happy events that define people's lives may result in a condition that can, in some cases, lead to death is very scary, the Swiss team's findings may help physicians differentiate between Takotsubo cardiomyopathy and heart attacks. Dr Ghadri further noted that "perhaps both happy and sad life events, while inherently distinct, share final common pathways in the central nervous system output", something that could lead to further research in future. 

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