New blood test designed to detect serious heart conditions

A 'broken heart' can look just like a heart attack, and now a new blood test may tell the difference.

A broken heart isn't just an expression. Extreme emotional or physical stress can sometimes cause a genuine heart condition that looks remarkably like a heart attack. 

It's called Takotsubo syndrome, or 'broken heart syndrome', and it overwhelmingly affects women after menopause. 

Someone experiencing it may suddenly develop severe chest pain, an abnormal ECG and blood tests showing signs of heart injury. Even the heart's pumping ability can be affected. 

The problem is that these are also classic signs of a heart attack. 

The important difference is what's happening inside the heart. A typical heart attack involves a problem with blood flow through a coronary artery. With broken heart syndrome, part of the heart muscle temporarily stops contracting normally. 

Why knowing the difference matters:

Doctors can't simply look at a woman with chest pain and decide that stress caused it, and missing a genuine heart attack could be deadly. 

So currently, many patients with suspected Takotsubo undergo coronary angiography, an invasive procedure in which a catheter is passed through an artery, usually from the wrist or groin, and dye is used to look for blockages in the coronary arteries. 

It's often only after doctors find no culprit blockage that Takotsubo becomes clear. 

That matters particularly for older women as 86-91 percent of the Takotsubo patients were women over 50. 

The researchers behind this new study identified the lack of a reliable early non-invasive tests and published their study in the European Heart Journal.

They studied 3,615 patients who had either acute coronary syndrome or Takotsubo syndrome taking blood samples when patients arrived at hospital. They measured a range of substances in the blood associated with heart-muscle stress, inflammation, cholesterol, blood-vessel damage and the body's stress response. 

They then used machine learning to identify which combination was best at distinguishing Takotsubo from a conventional heart attack. 

The result was a five-part scoring system called BioTAK which combines biological sex with four blood measurements. 

One marker called sLOX-1, associated with blood-vessel changes and plaque disruption, was much higher in acute coronary syndrome. Another called PAM, involved in sympathetic nervous-system activity and anxiety regulation, was higher in Takotsubo. 

While the two conditions that can look almost identical from the outside the study showed they leave very different chemical fingerprints in the blood. 

The researchers then tested BioTAK on another 1,792 patients and found that it was able to accurately place almost 90% of patients into either a high- or low-probability group for Takotsubo before they underwent invasive angiography. 

BioTak could eventually give doctors another piece of information much earlier in the process, potentially helping some women with Takotsubo avoid an invasive procedure they didn't ultimately need. 

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