8 ms·
Takotsubo cardiomyopathy triggered by wasabi consumption
- comex 7y agoMirror: https://a.qoid.us/takotsubo.pdf https://a.qoid.us/takotsubo.pdf
- King-Aaron 7y ago> a case of a 60-year-old woman that presented to the emergency department with chest pain after she attended a wedding and ate a large amount of wasabi, assuming it to be an avocado It should probably be cleared up that she suffered left ventricular dysfunction from eating too much wasabi - I had originally read the title thinking she was emotionally distressed from not getting her avocado, but instead it's more like a nervous system shock from the wasabi/wasabi poisoning(?) itself?
- lotsofpulp 7y agoI wonder if it was real or fake wasabi.
- missosoup 7y agoThere's not a lot of difference between real and fake wasabi. One is horseradish and the other is a close relative of horseradish.
- masklinn 7y ago> There's not a lot of difference […] One is horseradish and the other is a close relative of horseradish. Close relatives of the horseradish include woad (the ancient indigo source), turnips, rapeseed, cabbages, weeds (thale cress) and flowery shrubs & al. "Close relative" is not an indication of "not a lot of difference". You might as well say that mustard (also a close relative) is no different from wasabi.
- steve19 7y agoIt's the same chemical allyl isothiocyanate producing the flavor one way or the other. Horseradish isn't faking the flavor.
- missosoup 7y agoHave you tasted them? Most people wouldn't notice the difference if you swapped their regular fake wasabi for the real thing. The main difference is the colour, hence the fake stuff being dyed green.
- masklinn 7y agoYou're missing my point, which is that "close relative" says literally nothing about the effects given how varied "close relatives" of the horseradish are. You may well be right that there is no big difference between wasabi and horseradish, but them being "close relative" is not an actual argument for that unless they're much closer relative than just being in the same taxonomic family.
- missosoup 7y agoYou're sort of beating a strawman to death. I just said close relative without specifying how close or what kind of relationship. You picked that to mean "same taxonomic family' and having a go at that being a bad choice of qualification. Okay mate, but you picked it. Being pedantic for no productive reason at all backfires. Often.
- masklinn 7y ago> You're sort of beating a strawman to death. I just said close relative without specifying how close. And you picked that to mean "same taxonomic family' I didn't pick anything, I just looked up what the qualifier you picked meant. They're not the same species, they're not the same genus, they're the same taxonomic family, which also includes all the stuff I listed in my original comment.
- SantalBlush 7y ago
- pvaldes 7y agoBut can be a lot of difference on how is cultured and its origin.
- dotancohen 7y agoThe paper abstract is ambiguous on the cause being physical or emotional: > Takotsubo cardiomyopathy is a left ventricular dysfunction > that typically occurs after sudden intense emotional > or physical stress and mimics myocardial infarction.
- masklinn 7y agoI'd have expected emotional stress if she'd thought she'd slathered a dish in wasabi and only got avocado, if it was the other way around physical stress is pretty likely. Though I don't get how you'd eat "a large amount of wasabi", surely the first spoonful would tell you it's not avocado unless you don't have nerve endings, or a nose?
- tidenly 7y agoTo be fair, if you go in all gun-ho for a huge bite of real wasabi like you would avacado you're going to get a whole load more than most people would mix in with their sushi.
- bryanrasmussen 7y agoperhaps stuffy nose, takes big avocado slice sized scoops of wasabi to put on sandwich. Big bite to be sure of getting full slice of avocado and not having to bite it in half.
- russfink 7y agoI recently suffered three weeks of anosmia (loss of smell, taste) due to an acute sinus infection, and had some wasabi one evening. I could not taste it at all, and further, I did not get the eye watering, nose burning sensation I normally get that restricts me to a quarter teaspoon at most. If this woman had a similar issue, then yes, I can see how one could eat cups of wasabi and not notice.
- mirimir 7y agoFrom the paper (see nearby link): > In our case report, the amount of wasabi our patient consumed was unusually large, about a size of a teaspoon ... That's a lot of wasabi.
- rr-geil-j 7y agoI'm interested if this can indeed be categorized as 'poisoning'. If I understand it correctly, what the wasabi did is similar to what extreme emotional stress can also do... So if the effect of too much wasabi is considered 'poisoning', can extreme emotional stress be considered a poison?
- missosoup 7y agoI don't think we're talking about emotional stress here. Eating a teaspoon of wasabi is comparable to eating a teaspoon of habanero chilli sauce. It's a shock to the nervous system unless you have a tolerance.
- rob74 7y agoYeah, but the effects can be the same as those of extreme emotional stress, i.e. you start crying...
- missosoup 7y agoI think crying is a bit of a red herring here. Chilli and wasabi doesn't make you cry in the emotional sense. They stimulate the sinus and lacrimal glands to dilute and flush the irritant. There are other non-emotional triggers such as cutting onions. In that case we 'cry' to dilute and flush the sulphuric acid formed on the eye.
- Bartweiss 7y agoIt's interesting to note that this isn't just a difference in cause. The actual chemistry of tears changes based on trigger, which means there's an objective difference between crying from the pain of a hot pepper and tearing up as a physical reaction to it. (And this shouldn't be totally surprising; any mammal tears up at eye irritants like onions or dust, so humans obviously have some additional mechanism controlling emotional tears.) In fact, we apparently have (at least) four different types of tear! 'Basal' tears that keep our eyes wet have much higher lipid levels than any other type, and a higher fraction of their lipids are nonpolar. 'Reflex' and 'flush' tears are similar, they're both responses to irritants, but there seem to be differences between tears produced to remove solid/physical and liquid irritants. And then 'emotional' tears (which include pain) come with a host of hormones and other proteins basically absent from the general tear responses.
- mc32 7y agoDo they mean horseradish dressed up as wasabi (horseradish + mustard + coloring) or do they indeed mean real wasabi?
- Tharkun 7y agoThe paper seems to be Israeli, so presumably they mean the fake horseradish wasabi (which usually includes a tiny amount of real wasabi), as it's very rare to find real wasabi outside of Japan in meaningful quantities.
- CaptainZapp 7y agoI've seen it once in an upscale Zurich food department at 70$ a stick. But even in Japan you don't really get it served in quantity. That stuff is expensive.
- rezeroed 7y agoWhat kind of person would get emotionally distressed to the point of chest pains requiring an emergency department because they didn't get some avocado?
- journalctl 7y agoMillennials. (I’m a millennial, so I can say it!)
- lm28469 7y ago> because they didn't get some avocado? If you drink a shot of liquid LSD thinking it was vodka you don't die because "you didn't get some vodka?". She died because of the effect of wasabi, not because of the lack of avocado.
- hordeallergy 7y agoI think you've misunderstood - it was a response to the parent comment, which you seem to have missed.
- tomcorrigan 7y agoShe didn’t die
- tyingq 7y agoNo serious consequences, but a family member mistook fresh horseradish for applesauce in a dimly lit buffet once. Bad enough that we made an early exit :)
- oarabbus_ 7y agoHow's that? Horseradish effects last only a few seconds, unlike capsaicin, which can incapacitate someone for half an hour if present in high enough quantities.
- tyingq 7y agoEat a tablespoon. It's not pleasant. Wasabi (as in the posted story) is very similar to (and often IS) horseradish.
- CaptainZapp 7y agoHow you can confuse ersatz wasabi with avocado after taking a hearty bite mystifies me.
- gwd 7y agoMany years ago I overheard a guy say that with his color-blindness, wasabi looks almost exactly like bean dip. He was at a party once, saw some chips, and a bowl of what he though was bean dip next to it. He took a chip, scooped out a nice dollop of "bean dip", and popped it in his mouth before anyone could react; only to discover that it as definitely not bean dip. Luckily, he said, he really likes hot things, so while it was quite a surprise, it wasn't as nasty a shock as it could have been. But yeah, I don't see how you could be confused after the first bite. Edit: Somewhere else quotes the article as saying that the amount she'd eaten was "about a size of a teaspoon". That sounds similar.
- elmolino89 7y agoExcept the situation where the patient lost both the sense of smell and taste it is impossible imho. Even then I suspect the bodily reaction would indicate something is wrong with that "avocado". Either we are dealing with a psychiatric patient with some strange food addiction or an idiot using wasabi to who knows, burn calories, clean the nose or rotten tooth/whatever. The wasabi-avocado mistake sounds bogus to me.
- deleted 7y ago[deleted]
- black_puppydog 7y agoEvery time boulevardesque stuff like this gets too prominent on the HN frontpage, I go do a deep dive into daily politics to see if there is anything that is being buried.
- iamnotacrook 7y agoYeah, my assumption is also that HN is a Trump mouthpiece and it's vital that the nerd/man child/incel crowd are kept distracted from what's really going on otherwise they'll... sorry, what would people do if not distracted? Vote for an entirely different party at the next election presumably?
- wow-incredible 7y agoWoman panics. Confused by seemingly unsolicited and otherwise unfamiliar sensations, she inflicts an anxiety attack upon herself and visits an emergency room. And lo, a clickbait headline is born.
- lbj 7y agoAs a hacker, Im struggling to see how this is relevant to me?
- anon9001 7y agoI just assume everything has some small chance of killing me and try not to let it bother me too much.
- woadwarrior01 7y agoThis is very reminiscent of something which happened to a friend of mine a couple of years ago. She'd never eaten Japanese food before and I took her to a local sushi joint. She mistook wasabi for guacamole and ended up putting a large lump of it in her mouth. Fortunately, I noticed it immediately and asked her to spit it out, and by then her eyes were already teary and her breathing was quite labored. She didn't at first, perhaps because she was concerned about the embarrassment it'd cause. I had to repeat again, this time adding that she shouldn't be worried about anything and just spit it out and she did. Finally, rinsing the mouth with a jug full of cold water and eating some Gari (the pickled sweet ginger that's served with Sushi) alleviated her symptoms. I texted her the link to this hinting that I might have saved her life that day. Evidently, she still avoids Japanese food, thanks to that incident.
- tanr54ok 7y agoI’m curious with something as poorly understood as takotsubo, how they are so confident to rush to the conclusion that the wasabi must have triggered. I actually read the full text and I dont see any discussion on eliminating confounders, and this is just one case. At best this suggests further research is in order, but I’m not convinced anything can be definitively concluded here about the cardiotoxicity of wasabi. Case report or not, what passes for medical research makes me shake my head.
- carbocation 7y agoAs a cardiologist, this is also my perception (that you can’t assign causality to wasabi here). Not bad to put out a case report, since if there is truth here, this could spur future knowledge. But it seems unlikely that wasabi was causal compared to, say, the wedding itself.
- mywittyname 7y agoAside: now does a cardiologist become a member of Hacker News?
- teej 7y agoThere are a bunch of physicians of different specialties in this community. It’s not uncommon.
- bookofjoe 7y agoHear, hear: neurosurgical anesthesiologist (retired) here
- Cerium 7y agoYeah, how can we get more experts from various fields.
- carbocation 7y agoYour question prompted me to realize that I’ve been on HN for over a decade...
- not_a_cop75 7y agoIf I know anything about trending, there's going to be a few new Youtube channels now dedicated to wasabi ingestion, hopefully complete with medical personnel available if something should go wrong.
- agumonkey 7y agoCardiologist takotsubo wasn't real.
- howard941 7y agoI can't read the full article and I'm not a physician: Doubly handicapped. Why do you say it wasn't real?
- agumonkey 7y agosorry I sadly forgot a verb. "cardiologist said takotsubo wasn't real" (not my opinion)
- carbocation 7y agoWhat rationale did they give for that? There is a fair body of literature that they'd be overturning if they can show that stress cardiomyopathy, which we see often, is not real.
- agumonkey 7y agoI didn't ask more I was already too frustrated.
- SketchySeaBeast 7y agoI don't have access to the full article, but my only real question is - HOW? I don't know how you'd mistake a mouthful of wasabi for anything, except maybe trying to swallow a flamethrower. I can't imagine getting through the first mouthful and then moving on to the "eating a large amount" stage.
- lioeters 7y agoSince no one has mentioned it yet, the etymology of the phrase: The name "takotsubo syndrome" comes from the Japanese word takotsubo "octopus trap", because the left ventricle of the heart takes on a shape resembling an octopus trap when affected by this condition.
- rconti 7y agoMy parents are both very healthy; my dad's 80 and my mom is in her early 70s. They're typically mistaken for much (10-20 years) younger. So it was quite a shock to hear my mom was in the hospital for a heart issue a couple years back. She was ultimately diagnosed with Takotsubo. They had been watching a play at an outdoor theater, and during a very stressful/dramatic/revealing moment in the play (I think with loud drums, etc), she had these chest pains and was rushed to the hospital. Very interesting to learn about this condition I hadn't heard of. The "good news" is that, if you recover, and go a few weeks (I want to say 6+) without a recurrence, the heart re-strengthens and you're not any more likely to have heart issues again than anyone else. https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy
- bookofjoe 7y agohttp://archive.is/XsDrq http://archive.is/XsDrq