When heartbreak becomes physical: Understanding Broken Heart Syndrome

Whether in film, literature or a melodramatic soap opera, we’ve all heard the phrase “they died of a broken heart.” Though easy to assume it was coined purely for emotional impact, feelings of intense stress or grief—especially after a devastating breakup or the death of a loved one—can wreak havoc on the heart.

Known as Broken Heart Syndrome, or takotsubo cardiomyopathy, this usually temporary condition closely resembles a heart attack, causing symptoms of intense chest pain, shortness of breath and dizziness. However, the difference between this and a heart attack is that the arteries are not blocked.

According to Anand Haridas, MD, a cardiologist at Trinity Health Mid-Atlantic Medical Group’s Cardiology Langhorne, Broken Heart Syndrome is typically triggered by a stressful or emotional event that causes an acute surge of adrenaline in the body. Women, mainly those who are post-menopausal, are most at-risk.

“One of the common examples in my experience has been suddenly hearing about the death of a loved one. But any bad news can suddenly create a set of emotions and anxiety, which causes a lot of adrenaline and sudden symptoms of what seem to be a heart attack,” says Dr. Haridas.

Though Broken Heart Syndrome doesn’t involve blocked arteries like a heart attack, the adrenaline surge causes the body to respond in a similar manner.

“That sudden surge causes an acute weakening of the heart muscle. It’s like a sudden jolt to the heart and the heart is not expecting it. So the heart becomes dysfunctional for a prolonged period of time. When that dysfunction occurs, the body feels it immediately. Then the patient starts to experience chest discomfort, shortness of breath, fatigue and feeling like they’re going to faint,” says Dr. Haridas.

For anyone experiencing these symptoms, they should go to the hospital immediately, where a diagnosis can be made through an angiogram, EKG, echocardiogram and drawing troponin levels. Once Broken Heart Syndrome is confirmed, the patient is treated medically with beta blockers, ARBs and SGLT2 inhibitors, all of which help to improve heart function.

“If the patient takes these medications and participates in cardiac rehab as well, we see that—a good amount of the time—patients recover heart function. Six months to a year from then, they would have no idea that they had Broken Heart Syndrome,” says Dr. Haridas.

While the prognosis for Broken Heart Syndrome is typically good, there are instances where an individual could “die from a broken heart.” Though extremely rare, Broken Heart Syndrome can cause fatal heart failure or arrhythmia.

“This is one of those conditions where you can expect a full recovery as long as you seek medical attention. Do not neglect your symptoms,” says Dr. Haridas. “Unfortunately, there’s really no way to prevent Broken Heart Syndrome. It’s how your body reacts to stress, which is a very situational and personal thing. But if you’ve had it once, then you’re at a higher risk of developing it again in the future. So be mindful of how you handle stress in that second situation.”

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