Feeling the Physical Pain of a Broken Heart

By:    Medically Reviewed: Tom Iarocci, MD   Published: July 31, 2013

Sometimes, a broken heart is much more than experiencing emotional pain and anguish.

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Experiencing a highly emotional period like the death of a loved one can be heartbreaking. But did you know such emotional anguish can lead to an actual heart problem?

Broken heart syndrome, also known as stress cardiomyopathy, is a condition where the heart muscle weakens due to severe emotional or physical stress.

What exactly is broken heart syndrome?

Broken heart syndrome appears to develop after an extremely emotional event, such as sudden grief over the death of a spouse or parent. The condition is a type of cardiomyopathy that occurs when the left ventricle of the heart temporarily enlarges and does not pump blood efficiently. Broken heart syndrome was first described in 1990 in Japan as Takotsubo cardiomyopathy. The name originates from the shape taken on by the enlarged left ventricle, which looks like a Japanese fishing pot for catching octopus called a tako-tsubo. Although the condition generally reverses itself quickly, broken heart syndrome can be associated with severe illness and, in rare cases, death.

Hormones and other causes

The precise mechanism that causes broken heart syndrome is unknown. However, the timing between a stressful event and the development of symptoms suggests the emotional and physical response to the event is partly to blame. Other intense emotions can also cause the condition, including extreme surprise, profound fear and acute anger.

Various physical stressors such as asthma attacks, seizures or a stroke can also lead to broken heart syndrome.

During an extremely intense experience, the body produces hormones such as adrenaline and noradrenaline. Although it is not clearly understood how these stress hormones affect the heart, they may contribute to a narrowing of the arteries, which may lead to a temporary decrease in blood flow to the heart. In some instances, hormones may also cause the left ventricle to temporarily enlarge or balloon. This enlargement response may lead to symptoms of heart failure.

While chronic stress can affect the body in various ways, it does not appear to be one of the causes of broken heart syndrome. However, sudden and unexpected stress can be a primary contributor.

Symptoms similar to heart attack

Symptoms typically develop minutes to hours after experiencing an intense emotional stressor and closely resemble those of a heart attack. In fact, symptoms are so similar that broken heart syndrome is often initially diagnosed as a heart attack. Symptoms may include:

  • Breathing difficulty (including shortness of breath)
  • Chest pain
  • Fatigue or weakness
  • Abnormal heartbeats
  • Low blood pressure

These symptoms should never be ignored, and it is important to remember that broken heart syndrome temporarily weakens the heart muscle. Various complications are possible in this weakened state, such as life-threatening heart rhythms, shock and low blood pressure. Careful monitoring of patients with broken heart syndrome is needed to identify serious complications quickly.

What are your next steps?

Find a local grief support group within your network and begin sharing your circumstances. It is vital to remember that you are not alone and emergency services are widely available. Reach out to friends you can count on, and try incorporating mind-body exercises such as meditation or yoga into your schedule for a few minutes each day to cultivate calmness and fight depression naturally. Talk to a professional who can help. 

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sources
  • Johns Hopkins Medicine. “Frequently Asked Questions about Broken Heart Syndrome.” www.hopkinsmedicine.org. Accessed May 2013.
  • Roshanzamir, S, Showkathali, R. “Stress (Takotsubo) Cardiomyopathy – A Short Review.” Current Cardiology Reviews 2013. www.ncbi.nlm.nih.gov. Accessed May 2013.
  • Sealove, BA, Tiyyagura, S, Fuster, V. “Takotsubo cardiomyopathy.” Journal of Gen Intern Med. 2008; 23 (11). www.ncbi.nlm.nih.gov. Accessed June 2013.
  • Virani, SS, Khan, AN. “Takotsubo cardiomyopathy, or broken-heart syndrome.” Texas Heart Institute Journal 2007; 34 (1). www.ncbi.nlm.nih.gov. Accessed June 2013.