Is Broken Heart Syndrome real?

Yes, Broken Heart Syndrome (Takotsubo cardiomyopathy) is a well-known acute heart condition — but it might not be what you think. When you think of a broken heart, you may be thinking of the emotional aspect: The pain you feel when you dissolve a relationship, or the feeling of intense emotional distress or grief at the death of a loved one.

Research reveals these emotionally intense events are a factor in triggering a physical heart condition, Broken Heart Syndrome. You probably never considered these emotional stresses to manifest as a measurable physical health problem. The truth is, emotional distress of heartache, as well as major physical illness, can trigger a serious, and sometimes fatal, heart condition called Broken Heart Syndrome.

What is Broken Heart Syndrome?

My colleagues and I have studied this condition for more than 30 years. We now understand that Broken Heart Syndrome represents a sudden and profound injury to the heart muscle’s ability to contract. In many cases, nearly two-thirds of the heart’s muscle suddenly stops contracting, leading to chest pain, shock and even death. This condition feels just like a traditional heart attack except that the coronary arteries are not blocked when examined by an emergency coronary angiogram.

In fact, we now believe the Broken Heart Syndrome is caused by a rush of stress hormones such as epinephrine, which severely injure the heart muscle cells and lead to poor pumping function and sometimes cardiac arrest.

Physical vs. emotional states

We all can envision the emotional state of a broken heart, but it wasn’t until 1990 that a Japanese doctor was able to attach an actual physical condition to patients — it sprang from a widow who was grieving the loss of her husband, and she experienced the classic symptoms of the condition. But his observations were published in Japanese and not initially recognized outside of Japan.

As our team has spoken more closely with hundreds of patients over the years, a common thread was clear — an emotional or physical stressor (sometimes both) preceded the condition. These stressors run the gamut of emotions: While it’s most commonly the loss of a loved one, it can be touched off by fear, like public speaking, anger or even an intensely happy moment, such as winning the lottery. These emotions can precede the event by just a few minutes or longer.

Common symptoms of Broken Heart Syndrome

Our research has revealed there are some key symptoms to note when experiencing Broken Heart Syndrome:

• Chest pain or pressure
• Shortness of breath not explained by exertion
• Feeling faint, weak or experiencing dizziness

These symptoms are often quite intense, and many people think they may be having a heart attack. If you are experiencing any of these symptoms, you should be evaluated by a medical professional immediately.

Physical and emotional stress triggers

There is no single situation that causes Broken Heart Syndrome, and researchers and physicians are still trying to discover how to prevent it. We know it is related to the function of a person’s autonomic nervous system and represents an automatic response — a way we are all programmed — and the stress hormone epinephrine.

You likely know the feeling of that rush: A clap of thunder suddenly startles you, and your heart starts to race and beat harder almost instantaneously. In the case of Broken Heart Syndrome, the epinephrine that causes that sensation is released at a super-high level that damages the heart muscle and causes this condition.

Different situations pose different stress levels for people. I've treated patients whose symptoms were brought on after losing a home in a tornado, getting lost while driving and others who were dealing with the stress of public speaking.

There is no way currently to prevent Broken Heart Syndrome, but consistent overall stress management — meditation, breathing techniques, exercise — is never a bad idea. There is research underway to find medication to block this from happening in the first place, but science has yet to develop a medication powerful enough to stop the effects of hormones.

There is very good news when considering the consequences of Broken Heart Syndrome. The heart muscle damage is not permanent, and the contraction function will return to normal over a few days to weeks. We consider this as stunning the heart muscle. Nonetheless, the patient requires careful monitoring and sometimes advanced circulatory support until the heart muscle recovers.

Who is most at risk for Broken Heart Syndrome?

Broken Heart Syndrome overwhelmingly affects women, making up around 90 percent of cases. Most are over the age of 50. Women tend to experience it after emotional stress or duress.

Men who get it tend to experience it after a major acute health condition, such as overwhelming infection or trauma from an accident.

Risk factors also include a history of anxiety or depression.

Broken Heart Syndrome is a human condition that happens on every continent with the exception (so far) of Antarctica.

Can you die from Broken Heart Syndrome?

It is possible to die from Broken Heart Syndrome, which is why it’s critical to be evaluated if you are experiencing symptoms. You may require hospitalization, usually for a short duration. In most cases, recovery is complete and more rapid than recovery from a heart attack, and you are unlikely to develop the condition again.

Diagnostic process and tests

There are a variety of tests physicians can perform to arrive at an accurate Broken Heart Syndrome diagnosis. They may include:

• angiogram
• blood tests
• chest X-ray
• EKG
• heart MRI

Differences between heart attack vs. Broken Heart Syndrome

Heart attacks and Broken Heart Syndrome are two distinct health events, even though they share many of the same symptoms.

In a heart attack, the heart stops receiving proper blood flow due to a blocked artery or multiple blocked arteries, which can be seen on an angiogram.

Broken Heart Syndrome is a temporary weakening of the heart due to a flood of epinephrine, and it is most often triggered by intense emotional distress, although it can occasionally manifest after an intense illness. In contrast to a heart attack, imaging tests reveal no blockages are present. Instead, there is often heart enlargement and inadequate pumping.

Early recognition of the signs and medical attention are crucial, as Broken Heart Syndrome can be life-threatening in some cases. Most people fully recover within days to weeks with appropriate care and without much risk it will happen again, but prompt evaluation is essential. If you’re experiencing symptoms consistent with a heart attack or Broken Heart Syndrome, please seek medical attention urgently.