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Broken Heart Syndrome: Understanding Why It Happens and What You Can Do

Can an emotional event really “break” your heart? A cardiologist explains what triggers broken heart syndrome, how it differs from a heart attack and more.

Stress is the body’s natural and protective response to a challenge. But when it occurs in sudden and intense spurts – often beyond our control – it may cause damage to the heart.

Broken heart syndrome, also called stress-induced cardiomyopathy or Takotsubo syndrome, typically occurs after a physically or emotionally traumatic event, such as the loss of a loved one, divorce, car accidents, bad fights or near-drowning experiences. Studies have shown that, in rare circumstances, emotionally-charged positive events, such as a wedding or lottery win, may also be a cause for what some are now referring to as “happy heart syndrome.”

To better understand how extreme emotional experiences may take a toll on cardiovascular health, how to recognize the warning signs and what you can do about it, we spoke with cardiologist Dr. David O’Neil.

What causes broken heart syndrome?

Adrenaline and other stress hormones, such as epinephrine, are released when we undergo a significant amount of stress; this increases heart rate, blood pressure and mental concentration to help you respond in times of danger. In some cases, the heart is overwhelmed and damaged by this sudden and rapid stress. The heart muscle then weakens causing complications similar to heart failure, says Dr. O’Neil.

The exact cause of broken heart syndrome is unknown, and there aren’t any specific risk factors. “It can be pretty unpredictable,” he adds. “I’ve seen young and elderly people alike need treatment for broken heart syndrome.”

What does broken heart syndrome feel like?

This outpouring of adrenaline may lead to symptoms that mimic a heart attack. The heart rhythm is disrupted, muscle is weakened and small arteries may narrow, impacting blood flow. All of this can make you feel short of breath, and experience chest pain or heaviness, a rapid or irregular heartbeat, or fatigue and dizziness from low blood pressure.

How is broken heart syndrome different from a heart attack?

While symptoms mirror each other, broken heart syndrome and heart attacks don’t have the same underlying cause. The majority of heart attacks are caused by blocked arteries. This will never occur with broken heart syndrome, but there could be reduced blood flow to the heart.

“You can’t tell the difference between a heart attack and broken heart syndrome at home, without proper diagnosis,” explains Dr. O’Neil. “While broken heart syndrome is not as severe, if you experience these symptoms, it’s crucial that you receive immediate medical attention.”

Can you die from broken heart syndrome?

Yes, but it is incredibly rare, and it can be difficult to determine the cause if someone dies from it immediately, explains Dr. O’Neil. Reports indicate that only 1% of those with broken heart syndrome die from it. It typically has positive outcomes when treated quickly.

How is broken heart syndrome diagnosed?

Following a standard EKG (electrocardiogram) – which assesses the heart’s electrical activity for abnormalities – cardiac catheterization is used to view the arteries, says Dr. O’Neil.

“With broken heart syndrome, as opposed to a heart attack, the arteries won’t be blocked. The next step is the most definitive,” continues Dr. O’Neil. “An echocardiogram shows us the pattern of how your heart is pumping and can determine whether or not there’s strain or weakness in the heart muscle.”

How is broken heart syndrome treated?

Once diagnosis is clear and reveals the severity of your condition, you will likely be prescribed medications used for heart failure, such as ACE inhibitors or beta blockers. For many people, recovery will take a few weeks, says Dr. O’Neil. However, depending on severity and how well symptoms resolve, you may need additional assistance or a guided exercise plan through cardiac rehabilitation.

Dr. O’Neil also closely considers his patients’ anxiety levels and whether they could benefit from additional care, which could involve  medication or a referral for professional therapy.  It’s recommended that anyone who undergoes broken heart syndrome continue to follow up with their cardiologist on a yearly basis to stay on track of their heart health. Studies show they face a 5-10% risk  for recurrence within five years after recovery.

What should we know about happy heart syndrome?

Over the past decade, research has tied rare instances of stress-induced cardiomyopathy to positive events – such as a birthday party or birth of a new grandchild – rather than traumatic ones. Referred to as “happy heart syndrome,” symptoms and outcomes of the condition are no different than that of the typical broken heart syndrome.

“I’ve seen people who’ve experienced heart attacks at weddings, so there is potential for ‘happy heart syndrome’ as well,” says Dr. O’Neil. “The important thing is not to ignore or push off concerning symptoms just because of the event you’re at.”

What you can do

Emotions and stress responses are a natural part of life that you can’t avoid. However, if you suffer from chronic anxiety and are more prone to heightened stress responses, seeking professional help and better stress management may help your heart in the long-term. Reducing stress may lower blood pressure, cholesterol and your risk for heart disease; it may also reduce the likelihood for panic attacks that may mimic cardiac symptoms.

However, there’s no true way to prevent broken heart syndrome, says Dr. O’Neil, as it can strike in people who have no chronic anxiety and good heart health.

“Whether you suspect broken heart syndrome, happy heart syndrome or a heart attack, you can’t find a safe answer without going to the emergency room,” explains Dr. O’Neil. “Broken heart syndrome can be easy to treat when you have it checked quickly, but it can potentially be very dangerous if you don’t do anything about it.”

[Main image credit: Stratford]

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From the Experts, Healthy You