The Myocardial Stunning Hypothesis and Its Evolution
In the year 1971, a report with 170 cases of sudden cardiac death was published, and sympathetic activation played a prominent role in almost all cases. This implied that all the cases were dealing with intense stress, resulting from extreme anxiety or worry, prior to their eventual death.
Later in 1980, Hirsch and Cebelin illustrated described a series of death, which was followed by physical assault in which there was no internal injury in the post-mortem examination. Their study was the conclusion of 30-years research in Cuyahoga County, Ohio. The duo reported that the condition of myocardium displayed contraction between myofibrillar degeneration and band necrosis.
This was similar to what animals go through in situations of extreme stress and was linked to a high level of catecholamines. Based on this, they suggested that the stress caused a rise in catecholamine levels to generate lethal myofibrillar degeneration in humans.
The Japanese scientists who were initially involved described it as the occurrence of the hypokinetic segment in the heart that extends from the center of the heart to the mid-portion of the left ventricle. Their observation states that during this situation, the heart takes an end-systolic appearance that resembles a wide-mouthed and bellied pot that has a narrow neck similar to the octopus trap. This is where the name Takotsubo Cardiomyopathy came from in this scenario.