"Eventually…Your Body Just Can't No More": An Exploration of Patient Perspectives on Events Preceding Takotsubo Syndrome Episodes.

Abstract

Background: Takotsubo syndrome (TS) is preceded by emotional/physical triggers in two-thirds of cases and no trigger in one-third. Information on triggers is typically obtained in the emergency room, and patients rarely have the opportunity to describe in detail the event(s) leading to TS onset.

Objective: This study aimed to conduct a qualitative exploration of patients' narratives regarding the events preceding their TS episode.

Methods: Semistructured interviews inquiring about the presence, type (physical vs emotional), and timing of contiguous events/circumstances relative to symptoms onset were conducted within 2 to 12 weeks of hospital discharge for a TS episode. Interview recordings were transcribed, coded, and analyzed with applied thematic content analysis.

Results: Participants (n = 30; 97% women, 93% White; age, 63 ± 8 years) described equal proportions of acute events (onset < 4 days before admission, 43%) and chronic circumstances (onset > 4 days before admission, 43%) preceding their TS episodes. Acute events included emotional, physical, and mixed (ie, emotional and physical) factors. Chronic circumstances included emotional and mixed factors. Seventy percent of participants perceived these events/circumstances as contributing to their onset of TS.

Conclusions: Patients' narratives of the events contiguous to the TS episode are complex and often include factors that are chronic and/or emotional in nature. Future research should explore the potential importance of emotional aspects and chronic stress in the development of TS.