Happy events can trigger a heart condition known as takotsubo syndrome, according to research published today (Thursday) in the European Heart Journal [1]. 
 
 Takotsubo syndrome (TTS) is known as "broken heart syndrome" and is characterised by a sudden temporary weakening of the heart muscles that causes the left ventricle of the heart to balloon out at the bottom while the neck remains narrow, creating a shape resembling a Japanese octopus trap, from which it gets its name. Since this relatively rare condition was first described in 1990, evidence has suggested that it is typically triggered by episodes of severe emotional distress, such as grief, anger or fear, with patients developing chest pains and breathlessness. It can lead to heart attacks and death. 
 
 Now, for the first time, researchers have systematically analysed data from the largest group of patients diagnosed with TTS worldwide, and found that some patients have developed the condition after a happy or joyful event; they have named it "happy heart syndrome". 
 
 In 2011, Dr Christian Templin, principle investigator and consultant cardiologist, together with Dr Jelena Ghadri, resident cardiologist, established the first International Takotsubo Registry at the University Hospital Zurich in Switzerland. For this study they have analysed data from the first 1750 patients registered from the 25 collaborating centres in nine different countries [2]. 
 
 They found 485 patients where there was a definite emotional trigger. Of these, 20 (4%) had TTS that had been precipitated by happy and joyful events, such as a birthday party, wedding, surprise farewell celebration, a favourite rugby team winning a game, or the birth of a grandchild; 465 (96%) had occurred after sad and stressful events, such as death of a spouse, child or parent, attending a funeral, an accident, worry about illness, or relationship problems; one occurred after an obese patient got stuck in the bath. 
 
 Ninety-five percent of the patients were women in both the "broken hearts" and "happy hearts" groups, and the average age of patients was 65 among the "broken hearts" and 71 among the "happy hearts", confirming that the majority of TTS cases occur in post-menopausal women. 
 
 Dr Ghadri said the new findings should lead to a paradigm shift in clinical practice. "We have shown that the triggers for TTS can be more varied than previously thought. A TTS patient is no longer the classic "broken hearted" patient, and the disease can be preceded by positive emotions too. 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 TTS just as much as a similar patient presenting after a negative emotional event. Our findings broaden the clinical spectrum of TTS. They also suggest that happy and sad life events may share similar emotional pathways that can ultimately cause TTS." 
 
 The researchers found that "happy heart" patients were more likely to have hearts that had ballooned in the mid-ventricle than "broken heart" patients (35% versus 16%). Although this is a new and interesting finding, the small number of patients in this group means that more research needs to be conducted in order to discover whether or not it sheds any light on the mechanisms involved in TTS. 
 
 Dr Templin said further research was needed to understand the exact mechanisms underlying both the "broken" and "happy" heart variants of TTS. "We believe that TTS is a classic example of an intertwined feedback mechanism, involving the psychological and/or physical stimuli, the brain and the cardiovascular system. Perhaps both happy and sad life events, while inherently distinct, share final common pathways in the central nervous system output, which ultimately lead to TCS." 
 
 The researchers are working to understand further the relationship between the heart and the brain; they are using functional MRI to look at the workings of parts of the brain known to be involved in the processing of emotions, reactions, behaviour, decision-making and memory, such as the amygdala and the prefrontal cortex. 
 
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 Notes: 
 
 [1] "Happy heart syndrome: role of positive emotional stress in takotsubo syndrome", by Jelena R. Ghadri et al. European Heart Journal. doi:10.1093/eurheartj/ehv757 
 
 [2] The nine countries are Austria, Finland, France, Germany, Italy, Poland, Switzerland, UK and USA. ||||| It really is possible to die from a “broken heart,” but it’s also possible to die from the opposite: a heart so full of joy that it triggers the same condition as broken heart syndrome. In new research published in the European Health Journal, scientists found that extreme happiness could put just as much of a strain on your heart as severe distress or grief, leading to a condition known as takotsubo syndrome (TTS), or takotsubo cardiomyopathy. 
 
 The condition doesn’t occur gradually; rather, it happens suddenly during a moment of intense emotion, weakening the heart muscles and causing the left ventricle of the heart to expand at the bottom while the top remains narrow. The resulting shape of the ventricle resembles a Japanese octopus trap — hence the name, takotsubo. Symptoms include chest pain and shortness of breath, similar to a heart attack, but TTS can also lead to fatal arrhythmias, stroke, or heart failure. 
 
 CC BY-SA 3.0 
 
 CC BY-NC 2.0 
 
 TTS was first discovered in 1990 by Japanese researchers, and since then it has been linked mainly to negative emotions like stress, anger, fear, or sadness. In fact, researchers have found a correlation between an increase of the syndrome and major natural disasters around the world. In 2014, a study found that broken heart syndrome cases rose sharply following Tropical Storm Irene in affected states in the U.S. 
 
 In the latest study, the researchers used data from the International Takotsubo Registry at the University Hospital Zurich in Switzerland to examine the emotional events that triggered TTS. A total of 485 patients had an emotional trigger for their TTS; some four percent of these experienced a happy event before the heart condition occurred. These happy events included birthday parties, weddings, or surprise parties. The majority of cases — 96 percent — were triggered by sad or stressful events. Interestingly, 95 percent of people in the emotional trigger groups (whether sad or happy) were women, shadowing past research that has found the condition mainly occurs in older women. 
 
 The researchers also found there was a physical difference in cases triggered by happy emotional events; “happy heart” patients were more likely to experience an expansion in the mid-ventricle compared to the left ventricle in "broken heart" patients. 
 
 “We have shown that the triggers for TTS can be more varied than previously thought,” said Dr. Jelena Ghadri, a resident cardiologist at the University Hospital Zurich and an author of the study, in the press release. “A TTS patient is no longer the classic ‘broken hearted’ patient, and the disease can be preceded by positive emotions too… Our findings broaden the clinical spectrum of TTS.” 
 
 In addition, the study results may offer clues about emotional events beyond TTS, such as the general mind-body connection. “[The findings] suggest that happy and sad life events may share similar emotional pathways,” Ghadri noted, adding that “[w]e believe that TTS is a classic example of an intertwined feedback mechanism, involving the psychological and/or physical stimuli, the brain and the cardiovascular system. Perhaps both happy and sad life events, while inherently distinct, share final common pathways in the central nervous system output.” The researchers will continue to study the mechanisms behind different emotional triggers involved in TTS. 
 
 Source: Ghadri J, Sarcon A, Diekmann J, Bataiosu D, Cammann V, Jurisic S. Happy heart syndrome: role of positive emotional stress in takotsubo syndrome. European Heart Journal. 2016. ||||| Our general interest e-newsletter keeps you up to date on a wide variety of health topics. 
 
 Definition By Mayo Clinic Staff 
 
 Broken heart syndrome is a temporary heart condition that's often brought on by stressful situations, such as the death of a loved one. People with broken heart syndrome may have sudden chest pain or think they're having a heart attack. In broken heart syndrome, there's a temporary disruption of your heart's normal pumping function, while the remainder of the heart functions normally or with even more forceful contractions. 
 
 Broken heart syndrome may be caused by the heart's reaction to a surge of stress hormones. The condition may also be called takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy by doctors. 
 
 The symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in about a week. ||||| When Your Heart Breaks … (Literally). 
 
 
 
 “You can die of a broken heart — it's scientific fact — and my heart has been breaking since that very first day we met. I can feel it now, aching deep behind my rib cage the way it does every time we're together, beating a desperate rhythm: Love me. Love me. Love me.” — Abby McDonald, Getting Over Garrett Delaney 
 
 When you think of a broken heart, you may picture a cartoon drawing with a jagged line through it. But a real-life broken heart can actually lead to cardiac consequences. There are established ties between depression, mental health and heart disease. Read on for more information about how an extremely stressful event can have an impact on your heart. 
 
 
 
 Breakdown of a Broken Heart 
 
 Broken heart syndrome, also called stress-induced cardiomyopathy or takotsubo cardiomyopathy, can strike even if you’re healthy. (Tako tsubo, by the way, are octopus traps that resemble the pot-like shape of the stricken heart.) 
 
 Women are more likely than men to experience the sudden, intense chest pain — the reaction to a surge of stress hormones — that can be caused by an emotionally stressful event. It could be the death of a loved one or even a divorce, breakup or physical separation, betrayal or romantic rejection. It could even happen after a good shock (like winning the lottery.) 
 
 Broken heart syndrome may be misdiagnosed as a heart attack because the symptoms and test results are similar. In fact, tests show dramatic changes in rhythm and blood substances that are typical of a heart attack. But unlike a heart attack, there’s no evidence of blocked heart arteries in broken heart syndrome. 
 
 In broken heart syndrome, a part of your heart temporarily enlarges and doesn’t pump well, while the rest of your heart functions normally or with even more forceful contractions. Researchers are just starting to learn the causes, and how to diagnose and treat it. 
 
 The bad news: Broken heart syndrome can lead to severe, short-term heart muscle failure. 
 
 
 
 The good news: Broken heart syndrome is usually treatable. Most people who experience it make a full recovery within weeks, and they’re at low risk for it happening again (although in rare cases in can be fatal). 
 
 
 
 What To Look For: Signs and Symptoms 
 
 The most common signs and symptoms of broken heart syndrome are angina (chest pain) and shortness of breath. You can experience these things even if you have no history of heart disease. 
 
 
 
 Arrhythmias (irregular heartbeats) or cardiogenic shock also may occur with broken heart syndrome. Cardiogenic shock is a condition in which a suddenly weakened heart can’t pump enough blood to meet the body’s needs, and it can be fatal if it isn’t treated right away. (When people die from heart attacks, cardiogenic shock is the most common cause of death.) 
 
 
 
 Heart attack and broken heart syndrome: What’s the difference? 
 
 
 
 Some signs and symptoms of broken heart syndrome differ from those of heart attack. In broken heart syndrome, symptoms occur suddenly after extreme emotional or physical stress. Here are some other differences: 
 
 EKG (a test that records the heart’s electric activity) results don’t look the same as the EKG results for a person having a heart attack. 
 
 Blood tests show no signs of heart damage. 
 
 Tests show no signs of blockages in the coronary arteries. 
 
 Tests show ballooning and unusual movement of the lower left heart chamber (left ventricle). 
 
 Recovery time is quick, usually within days or weeks (compared with the recovery time of a month or more for a heart attack). 
 
 If your doctor thinks you have broken heart syndrome, you may need coronary angiography , a test that uses dye and special X-rays to show the insides of your coronary arteries. Other diagnostic tests are blood tests, EKG, echocardiography (a painless test that uses sound waves to create moving pictures of your heart) and cardiac MRI To keep tabs on your heart health, your doctor may recommend anabout a month after you’re diagnosed with the syndrome. Talk with your doctor about how often you should schedule follow-up visits. ||||| A rare condition known as "broken heart syndrome" is usually brought on by an emotionally devastating or stressful event. But now, a new study from Europe reveals the condition can also be brought on by happy events and positive emotions. 
 
 This is the first time researchers have linked pleasant experiences with broken heart syndrome, which causes a sudden but temporary weakness in the heart muscle, according to the findings, published on Thursday (March 3) in the European Heart Journal. However, many negative forms of emotional stress, including grief, fear, anger and anxiety, are known to trigger episodes of the condition. 
 
 Broken heart syndrome can be easily confused with a heart attack because people who experience the syndrome have symptoms such as chest pain and shortness of breath, the study said. These symptoms typically appear within minutes or hours after a person has been through a stressful experience. 
 
 The syndrome is also referred to as stress cardiomyopathy, but was originally named takotsubo syndrome (TTS) by the Japanese researcher who first described it in 1990. The researcher called it that because the heart's bulging appearance in people with the condition resembled the shape of a "takotsubo," or octopus pot. [10 Amazing Facts About Your Heart] 
 
 Previous studies on broken heart syndrome have focused exclusively on the negative stressors known to bring on the condition's symptoms. But in conducting this new study, the researchers wondered whether joyful experiences may also trigger the condition in some people. 
 
 To find out, they analyzed data collected from 1,750 people who were part of the International Takotsubo Registry, a database of men and women in the United States and eight countries in Europe who were diagnosed with the condition. 
 
 The researchers found that 485 participants in the study had definite emotional triggers preceding the onset of their symptoms. Of these, the vast majority of participants experienced a negative emotional event, such as the death of a loved one, a frightening experience like an accident or friend's illness, an argument, or a financial problem. 
 
 But in 20 people, or about 4 percent of participants, a positive emotional event — a birthday party, becoming a grandmother or great grandmother, a son's wedding, or an unexpected visit from a favorite relative —brought on their symptoms. 
 
 Happy heart 
 
 These findings broaden the spectrum of emotions known to cause broken heart syndrome, said study author Dr. Jelena R. Ghadri, a cardiologist and research fellow at University Hospital Zurich in Switzerland. 
 
 Although only a small percentage of participants were diagnosed with "broken heart syndrome" after a joyful or socially desirable event, the researchers were surprised to find that positive emotions can lead to TTS, Ghadri said. 
 
 The researchers dubbed the 20 individuals with a positive trigger as the "happy hearts," comparing them to the 465 people with a negative preceding event, categorized as "broken hearts." 
 
 After reviewing both groups' medical records for a variety of factors — such as cardiovascular risks, results from lab and heart imaging tests, symptoms, and hospital stays — the researchers found many similarities between the "happy hearts" and "broken hearts." 
 
 Women represented about 95 percent of those affected in both groups. And the two groups had similar symptoms, such as chest pain and shortness of breath, when they were admitted to the hospital. 
 
 The study also found that happy hearts were slightly older (71), on average, than broken hearts (65). 
 
 A heart-brain connection? 
 
 One of the noticeable differences between the two groups was that imaging tests revealed that happy hearts were more likely to have a certain type of the syndrome, called the midventricular type, than were broken hearts.(There are four different types of TTS.) Thirty-five percent of happy hearts had the midventricular type, compared with 16 percent of the broken hearts. [7 Weirdest Medical Conditions] 
 
 Although this was an interesting and novel observation, the underlying mechanism that may be responsible for this finding is unknown, Ghadri told Live Science. 
 
 The research team will now investigate brain activity patterns in the people with "happy heart syndrome" and compare those patterns to those found in people with "broken heart syndrome" to learn more about the interactions between the heart and the brain. For now, it's unclear exactly how a person's emotional states play a role in the development of this heart-muscle weakening condition. 
 
 One hypothesis is that a surge of stress hormones, such as adrenaline, may temporarily damage the hearts of some people, said the Mayo Clinic. 
 
 Perhaps happy and negative events, while distinct in nature, share a common emotional pathway in the central nervous system, which can ultimately trigger TTS, Ghadri speculated. 
 
 While researchers learn more, the good news is that most people with TTS often make a quick and full recovery. The heart is weakened for only a brief period of time, and it tends to have no permanent or long-term damage, according to information from the National Heart, Lung and Blood Institute. 
 
 Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science.
– Since at least 1990, scientists have known humans can die of a "broken heart." And while most of the stress that brings on this rare condition, known as takotsubo syndrome (TTS) or stress-induced cardiomyopathy, are heartbreaking—the death of a loved one, divorce, even natural disasters—researchers at University Hospital Zurich in Switzerland now say a small percentage of TTS sufferers came down with the condition after a happy event, a press release notes. This "happy heart" study, published in the European Heart Journal, examined data collected from 1,750 TTS patients who had signed up with the International Takotsubo Registry, a database of both men and women from the US and eight European countries, per Live Science. The researchers found 485 of those with TTS—which temporarily weakens heart muscles and makes the left ventricle balloon at the bottom while the neck stays narrow, causing symptoms similar to a heart attack, including chest pain—had experienced a "definite emotional trigger." Of those triggers, 96% were linked to sad or stressful events, but 4% were tied to joyous events such as a surprise party or a favorite sports team winning a game. A stunning 95% of both "broken heart" and "happy heart" patients were women. There was a slight difference in how the TTS played out, too: More "happy heart" patients (35%) had hearts that ballooned out in the mid-ventricle than their brokenhearted counterparts (16%), though researchers have to study this more to see what it means. "We believe that TTS is a classic example of an intertwined feedback mechanism, involving the psychological and/or physical stimuli, the brain, and the cardiovascular system," co-author Dr. Christian Templin says. "Perhaps both happy and sad life events, while inherently distinct, share final common pathways in the central nervous system output, which ultimately lead to [TTS]." (Yoga may help TTS patients.)