Tuesday, July 23, 2019

Screen patients with broken heart syndrome for cancer

People with broken heart syndrome, also known as Takotsubo syndrome (TTS), should be screened for cancer, suggests a new study published in the Journal of the American Heart Association. And, a history of malignancy might increase the risk for TTS.

In the study of 1,604 people with broken heart syndrome, 16.6% showed an association with malignancy. The most frequent type of malignancy was breast cancer 26.2%, followed by tumors affecting the gastrointestinal system 16.1%, respiratory tract 15.4%, internal sex organs 14.6%, skin 13.1%, lymphatic system 7.1%, endocrine organs 6.7%, urinary tract 5.2%, hematologic 3.0% and the central nervous system 2.2%.

Patients with malignancy were older and more likely to have physical triggers (after a medical intervention or physical trauma), but less likely to have emotional trigger as the inciting event compared with those without malignancy. Longterm mortality was higher in patients with malignancy while shortterm outcome was comparable. Malignancy was as an independent predictor of longterm mortality.

Creactive protein levels were significantly higher in the TTS patients with malignancy in those without malignancy, while the total white blood cell counts were not different between the groups. The raised CRP levels were attributed to as a marker of the comorbidity.

TTS patients with malignancy on initial presentation experienced chest pain less frequently, but had dyspnea more often.

(Source: Journal of the American Heart Association, Published July 17, 2019)

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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