Happy Heart Syndrome (HHS), a variant of Takotsubo syndrome (TTS), represents a unique cardiovascular condition triggered by positive rather than negative emotional stressors. This narrative review synthesizes current evidence regarding HHS, which accounts for approximately 4.1% of emotionally-triggered TTS and 1–1.5% of all TTS cases. While sharing clinical presentation similar to the more common negative emotion-triggered TTS (broken heart syndrome), HHS demonstrates distinct characteristics, including a higher male prevalence and more frequent midventricular ballooning patterns. The pathophysiology involves complex interactions between emotional processing, neurohormonal activation, and cardiovascular response, with evidence suggesting different threshold requirements for positive versus negative emotional triggers. Clinical presentation mirrors that of acute myocardial infarction with chest pain, dyspnea, electrocardiographic changes, and elevated cardiac biomarkers, necessitating comprehensive diagnostic workup including coronary angiography, echocardiography, and cardiac magnetic resonance imaging. Although complications such as arrhythmias, ventricular thrombosis, and cardiogenic shock can occur, HHS may be associated with lower rates of in-hospital complications and long- term mortality. Recurrence rates are low, with preventive strategies focusing on emotional regulation and medical optimization. This review highlights the importance of recognizing positive emotional triggers in cardiovascular disease and suggests directions for future research in this emerging field.
Objectives: The objective of the study is to evaluate the effects of a hatha yoga intervention on body composition, cardiorespiratory fitness, and mental health in sedentary working women. Materials and Methods: A pre–post interventional study was conducted on 63 sedentary working women aged between 25 and 50 years. Participants underwent weekly three hatha yoga sessions for 16 weeks that included asanas, pranayama, and detoxification/shatkarmas (neti, nauli, trataka, kapalbhati). Pre- and post-intervention assessments included body composition, blood pressure (BP), lipid profile, fasting glucose, VO2 max, 6-min walk test, respiratory rate, peak expiratory flow rate (PEFR), patient health questionnaire-9, generalized anxiety disorder-7 and World Health Organization-5 well-being index. Results: Significant improvements were observed in physiological parameters such as body mass index, fat mass, waist–hip circumference, BP. No significant change was observed in weight and lean body mass. Cardiorespiratory parameters such as VO2 max, 6-min walk distance, endurance time, and PEFR increased significantly, while respiratory rate decreased markedly, demonstrating substantial gains in cardiorespiratory fitness and improved pulmonary function with highly significant values between pre–post intervention ( p < 0.001). Total cholesterol did not change significantly, but high-density lipoprotein-cholesterol increased significantly and low-density lipoprotein-cholesterol decreased significantly, indicating an improved cardiovascular profile. Fasting blood glucose and triglycerides showed significant reductions, whereas total cholesterol did not change significantly. The inclusion of cleansing techniques likely enhanced metabolic and respiratory benefits. Conclusion: Hatha Yoga with its integrated physical, respiratory, and cleansing practices is a powerful, low-cost intervention for improving physical health, cardiorespiratory fitness, metabolic balance, and emotional well-being in sedentary working women. Larger studies should be conducted to further research and provide evidence of the role of Shatkarmas/detoxification techniques in preventive health.
Objectives: The present study was undertaken to systematically evaluate the diagnostic utility and association of heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) in prediabetic women for early detection of cardiac autonomic neuropathy (CAN). By examining these three interlinked regulatory domains within the same individuals, this study aimed to capture a comprehensive snapshot of early neurocardiovascular dysregulation in prediabetes. Materials and Methods: This cross-sectional, comparative study was conducted amongst a total of 100 women, comprising 50 prediabetic women and 50 normoglycemic controls with no history of diabetes, hypertension, cardiovascular disease, or autonomic neuropathy. Individuals with smoking, alcohol use, thyroid disease, arrhythmias, anemia, or medications affecting autonomic function were excluded. All participants underwent detailed clinical evaluation, anthropometry, and fasting biochemical testing including fasting blood sugar (FBS), glycosylated hemoglobin A1c (HbA1c), lipid profile, and renal parameters. Resting blood pressure was measured, and systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) variability were recorded. Cardiac autonomic function testing included: (1) HRV measured using a 10-min electrocardiogram recording analyzed for time-domain (standard deviation of normal-to-normal, root mean square of successive differences, pNN50), frequency-domain (low frequency [LF], high frequency [HF], LF/HF ratio), and non-linear indices (standard deviation [SD]1, SD2). (2) Spontaneous BRS assessed using the sequence method for SBP-BRS, DBP-BRS, and MBP-BRS, and (3) BPV was calculated from beat-to-beat recordings of SBP, DBP, and mean arterial pressure. Statistical analysis used appropriate tests for group comparison, Pearson correlation for associations, multinomial logistic regression for independent predictors, and receiver operating characteristic (ROC) curves to assess diagnostic performance, with area under the curve (AUC) values interpreted per standard guidelines. ROC curves were constructed using prediabetes status as the binary outcome variable to assess the discriminatory ability of autonomic parameters. Results: Among 100 women (50 prediabetic; 50 controls), prediabetes was associated with significantly higher cardiometabolic risk (higher body mass index, SBP/DBP, low-density lipoprotein, triglycerides and HbA1c. Prediabetic women demonstrated markedly reduced HRV across time, frequency and non-linear indices ( p < 0.001), with excellent discriminatory ability (AUC 0.86–0.90). BRS was significantly lower in prediabetics ( p < 0.001), demonstrated good discriminatory ability (AUC 0.87). 44% met criteria for definite CAN, and 86% had ≥1 abnormal autonomic test. BPV indices did not differ significantly at the group level; however, fasting glucose showed strong negative correlations with short-term SBP, DBP and MBP variability in prediabetics. Multivariable models showed that HRV impairment was independently associated with both SBP load and HbA1c. Conclusion: Prediabetic women exhibit early, substantial, and measurable cardiac autonomic dysfunction, with HRV and BRS demonstrating good discriminatory ability. BPV changes appear subtle but correlate strongly with glycemia, suggesting a possible role as an early vascular-autonomic marker. Early autonomic assessment in prediabetes may enable timely detection of high-risk individuals.
Transcatheter aortic valve implantation (TAVI) has become a cornerstone in the management of severe aortic stenosis across a broad spectrum of surgical risk categories. Women undergoing TAVI represent nearly half of all patients, yet they exhibit distinct baseline, anatomical, procedural, and outcome characteristics compared to men. Women are typically older at presentation, have smaller aortic annuli and ilio-femoral vessels, and exhibit distinct patterns of left ventricular remodeling. These anatomical and physiological features influence device selection, procedural strategy, and risk of complications. Despite higher procedural risks – especially vascular and bleeding complications – women demonstrate superior long-term survival after TAVI compared to men. This article provides a comprehensive, women-focused review of TAVI by incorporating evidence from major registries, clinical trials, and recent sex-specific reviews. It explores baseline differences, procedural implications, complications, outcomes, mechanistic explanations, clinical recommendations, and future research priorities, aiming to highlight the need for a women-centric approach to TAVI.
Retroperitoneal hemorrhage is a rare but life-threatening complication of femoral arterial access during coronary angiography. We report a 73-year-old hypertensive, non-diabetic woman with prior coronary artery bypass grafting (CABG) (2013) and mild aortic stenosis, who underwent pre- aortic valve replacement (AVR) coronary angiography. Two hours post-procedure, she developed hypotension responsive to fluids; at 3 h, she reported hypotension with acute abdominal pain. Bedside ultrasound revealed a 12 × 6 × 6 cm perirenal hematoma. Computed tomography aortogram showed active extravasation from the lower pole of the left kidney. Review of angiography demonstrated inadvertent non-fluoroscopic advancement of a Terumo Glidewire into the left renal artery. Superselective coil embolization and polyvinyl alcohol particle infusion achieved hemostasis. The patient’s course was complicated by left ventricular failure and acute kidney injury, necessitating an 8-day hospital stay for recovery. She later underwent a successful transcatheter aortic valve replacement and continues to do well at 2-year follow-up. This case underscores the necessity of wire advancement under fluoroscopic guidance and vigilant post-procedural monitoring.
