Case Western Reserve University (CWRU; Cleveland, OH, USA), and other institutions conducted a retrospective cohort study involving 1,914 patients to examine the incidence of stress cardiomyopathy--also known as Takotsubo syndrome--presenting with acute coronary syndrome (ACS) during the COVID-19 pandemic, comparing them to four control groups presenting across four distinct timelines prior to the pandemic. The main outcome and measure included incidence of stress cardiomyopathy.

The results revealed a significant increase in the 258 patients presenting with ACS during the pandemic (7.8%), compared with the pre-pandemic incidence of 1.7%. In addition, patients hospitalized with stress cardiomyopathy during the pandemic had a longer length of stay than those in the pre-pandemic period; however, there was no significant difference in mortality between the groups. All patients diagnosed with stress cardiomyopathy tested negative for COVID-19. The study was published on July 9, 2020, in JAMA Network Open.

“The COVID-19 pandemic has brought about multiple levels of stress in people's lives across the country and world,” said co-lead author Ankur Kalra, MD, of CC. “People are not only worried about themselves or their families becoming ill, they are dealing with economic and emotional issues, societal problems, and potential loneliness and isolation. The stress can have physical effects on our bodies and our hearts, as evidenced by the increasing diagnoses of stress cardiomyopathy we are experiencing."

Takotsubo syndrome occurs in response to physical or emotional distress and causes dysfunction or failure in the heart muscle. Patients typically experience symptoms similar to a heart attack, such as chest pain and shortness of breath, but usually do not have acutely blocked coronary arteries. The left ventricle of the heart, however, may show enlargement. Other symptoms include irregular heartbeat, fainting, low blood pressure, and cardiogenic shock. Patients generally recover in a matter of days or weeks, although the condition can occasionally cause major adverse cardiac and cerebrovascular events, and rarely can be fatal.

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