Takotsubo cardiomyopathy or Takotsubo syndrome (TTS), also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart.^[3] It usually appears after a significant stressor, either physical or emotional; when caused by the latter, the condition is sometimes called broken heart syndrome.^[4] Examples of physical stressors that can cause TTS are sepsis, shock, and pheochromocytoma, and emotional stressors include bereavement, divorce, or the loss of a job.^[5] Reviews suggest that of patients diagnosed with the condition, about 70-80% recently experienced a major stressor including 41-50% with a physical stressor and 26-30% with an emotional stressor.^[6][7] TTS can also appear in patients who have not experienced major stressors.^[8][7]

Takotsubo cardiomyopathy
Other names	Transient apical ballooning syndrome,[1] apical ballooning cardiomyopathy,[2]stress-induced cardiomyopathy, broken-heart syndrome
Schematic representation of takotsubo cardiomyopathy (A) compared to a normal heart (B)
Specialty	Cardiology

The pathophysiology is not well understood, but a sudden massive surge of catecholamines such as adrenaline and norepinephrine from extreme stress or a tumor secreting these chemicals is thought to play a central role.^[9] Excess catecholamines, when released directly by nerves that stimulate cardiac muscle cells, have a toxic effect and can lead to decreased cardiac muscular function or "stunning".^[10][11]Further, this adrenaline surge triggers the arteries to tighten, thereby raising blood pressure and placing more stress on the heart, and may lead to spasm of the coronary arteries that supply blood to the heart muscle.^[9] This impairs the arteries from delivering adequate blood flow and oxygen to the heart muscle.^[9] Together, these events can lead to congestive heart failure and decrease the heart's output of blood with each squeeze.^{[9](from Internet)}

The public and even most MDs other than cardiologists are not aware of this clinical entity

called Takotsubo Syndrome or  stress cardiomyopathy or broken heart syndrome, etc,

where a typical patient presents to ER with symptoms and signs and EKG findings

suggesting acute MI. They are usually subjected to immediate cardiac catheterization

and coronary angiography establishing Dx.

As a director of cardiac cath lab from 1971 until 2000, I encountered a good number of them

and soon had a collection of such patients 

and observed two things, first how important a role  the stress in life plays in pathogenesis of heart disease,

two the prognosis of this condition 

as well as any heart condition depends upon how well one manages his stress in life.

In other words two patients can have identical

cad with a way different prognosis depending upon how well each patient manages his stress.

This current article is saying that because of the Pandemic related stress the incidence of this broken heart syndrome increased,

which is no surprise, yet a general warning we are all in the same boat under much stress

that would increase the incidence  of other medical complications.

The clinical entity was documented by Sato et al in Japan in 1991.

https://eur06.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.stresshumain.ca%2FDocuments%2Fpdf%2FMesures-physiologiques%2FCESH_howMesureStress-MB.pdf&data=02%7C01%7C%7C9630edb7263b434ce17208d824dbb677%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637299873959111026&sdata=8Fcm8VfFL5kjz74gSFq%2BYU%2FCfLqgIdR29pXablno%2Bkk%3D&reserved=0

So we all know excess mental stress is not good for the heart, but doing something about it 

has to be sincere joint effort between the patient and the treating physician.

The treating physician pressed with time usually have no time to listen to complicated

life story of his patient so that he is always ready to prescribe Valium, Xanax, whatever 

to lessen the mental pain of his patient, which often leads to new complication and addiction.

The physician almost always has no way measuring the stress level objectively so that

in the end it is becoming like a blind man leading a blind man.

I must say, as a practitioner, I used to find it most challenging to guesstimate the degree or

the severity of my patient's stress. Most of the time physicians wind up being busy dealing with

consequences of stress such as Takotsubo syndrome.

We hear a lot of incidences where a person says he is going to die and then he really dies

even though he is not critically sick enough to die.

I feel like there must be a "Self-Killing Hormone" that causes the person to die.

TTS syndrome is a good example. The mind is the one that precipitates such a condition.

I think depression, despair, severe stress, and etc. can bring this hormone.

We should actively and intentionally keep ourselves from getting into such mental conditions.

Try to be cheerful, hopeful, happy, and optimistic at any time, anywhere, or at any circumstances.

No wonder, idiots lacking any conscience and empathy tend to live long, and intellectuals live shorter.

I bet you, Trump, Barr, and Roger Stone will live longer than we do. LOL.

What you said about Trump and his crooked friends is funny but

does make medical sense in that they tend to outlive their contemporaries 

because of their congenitally insensitive hearts.

Many years ago I realized one evening while making hospital round

in critical cardiac care units all of my patients, some 12 of them were

nicest human beings all around who didn't deserve to be critically ill

in their prime ages. I purposely gathered all the nurses taking care of them

asked them whether they agreed with me or not. They all said, "yes".

The bottom line is that unfortunately being nice to everybody around 

at work or home  brought premature heart attacks to these folks.

I told all the nurses that evening that we all need to learn to be nasty

instead of always trying to be nice absorbing everybody's stress and problems 

if we want to live a little longer in this rough world.