Happy Heart Syndrome: Takotsubo syndrome may be triggered by happy events also

Results

• Of 2,482 patients in the registry, 910 patients (36.7%) exhibited an emotional trigger consisting of 873 "broken hearts" (95.9%) and 37 "happy hearts" (4.1%).
• Consequently, the prevalence of pleasant emotional triggers was 1.5% of all TTS cases.
• Compared with patients with TTS with negative preceding events, patients with happy heart syndrome were more frequently male (18.9% vs 5.0%; P < 0.01) and had a higher prevalence of atypical ballooning patterns (27.0% vs 12.5%; P = 0.01), particularly midventricular ballooning. In-hospital complications, including death, pulmonary edema, cardiogenic shock, or stroke (8.1% vs 12.3%; P = 0.45), and long-term mortality rates (2.7% vs 8.8%; P = 0.20) were similar in "happy hearts" and "broken hearts."

Thus, happy heart syndrome is a rare type of TTS characterized by a higher prevalence of male patients and atypical, non-apical ballooning than patients with negative emotional stressors. Despite similar short- and long-term outcomes in our study, additional data are needed to explore whether numerically lower event rates in "happy hearts" would be statistically significant in a larger sample size.

Reference:

Happy Heart Syndrome: Frequency, Characteristics, and Outcome of Takotsubo Syndrome Triggered by Positive Life Events by Thomas Stiermaier et al. published in the JACC: Heart Failure.

DOI: 10.1016/j.jchf.2022.02.015