Is broken heart syndrome real?

When we think of a broken heart, we think of lost love, a soul mate dying, or other types of romantic situations. After Valentine’s Day yesterday, hearts and flowers (and chocolate!) are still on our minds. But a real broken heart can actually lead to cardiac consequences. There are established ties between depression, mental health and heart disease. Read on for more information about how an extremely stressful event can have an impact on your heart.

Broken heart syndrome, also called stress-induced cardiomyopathy or takotsubo cardiomyopathy, can strike even if you’re healthy. Women are more likely than men to experience the sudden, intense chest pain, the reaction to a surge of stress hormones, which can be caused by an emotionally stressful event. It could be the death of a loved one or even a divorce, breakup or physical separation, betrayal or romantic rejection. It could even happen after a good shock, like a wedding or winning the lottery.(1) The Japanese word takotsubo translates to "octopus pot," resembling the shape of the left ventricle during systole on imaging studies. Although the exact etiology is still unknown, the syndrome appears to be triggered by a significant emotional or physical stressor.(2)

Octopus pot

Broken heart syndrome may be misdiagnosed as a heart attack because the symptoms and test results are similar. Actually, tests show dramatic changes in rhythm and blood substances that are typical of a heart attack. Dissimilar to a heart attack, there is usually no evidence of blocked heart arteries in broken heart syndrome.(1) In this syndrome, a part of the heart temporarily enlarges and doesn’t pump well, while the rest of your heart functions normally or with even more forceful contractions. Researchers are just starting to learn the causes, and how to diagnose and treat it. Broken heart syndrome can lead to severe, short-term heart muscle failure, but is usually treatable. Most people who experience it make a full recovery within weeks, and they’re at low risk for it happening again. In rare cases in can be fatal.

Electrocardiogram of a patient with takotsubo cardiomyopathy demonstrating ST-segment elevation in anterior and inferior leads.(2) The most common signs and symptoms of broken heart syndrome are angina chest pain and shortness of breath. Arrhythmias (irregular heartbeats) or cardiogenic shock also may occur with broken heart syndrome. There are different types of arrhythmias, including: atrial fibrillation; bradycardia; conduction disorders; premature contraction; tachycardia; ventricular fibrillation; and other rhythm disorders.(3) The normal heart is a strong, muscular pump a little larger than a fist. It pumps blood continuously through the circulatory system. Each day the average heart beats, expands and contracts 100,000 times, and pumps about 2,000 gallons of blood.(3) In a 70-year lifetime, an average human heart beats more than 2.5 billion times!(3)

It is sometimes difficult to discern a heart attack from broken heart syndrome. In an electrocardiogram (EKG), results don’t look the same as the EKG results for a person having a heart attack. Blood tests show no signs of heart damage in broken heart syndrome. Tests show no signs of blockages in the coronary arteries, but may show ballooning and unusual movement of the lower left heart chamber (left ventricle). Recovery time is quick, usually within days or weeks, compared with the recovery time of a month or more for a heart attack.(3) If a cardiologist suspects this syndrome, he/she may suggest a coronary angiogram.(4) Other diagnostic tests are blood tests, EKG, echocardiography (a painless test that uses sound waves to create moving pictures of your heart) and cardiac MRI.