Is “Broken Heart Syndrome” Real?

In 2005, some Johns Hopkins researchers made waves when the New England Journal of Medicine published their scientific article detailing “Broken Heart Syndrome” on Valentine’s Day.

Of course, in the medical community we don’t call it “broken heart syndrome.” We call it stress cardiomyopathy, to mean a stress-induced weakening of the heart muscle. However, contrary to popular belief, the idea behind broken heart syndrome is very real. Emotional stress can cripple the heart.

Emotional stress can be toxic

We have all heard these stories. A woman falls over dead after getting jilted by a former lover. A mother keels over just after her daughter gives birth to her grandson. A grandmother suffers a heart attack when her house burns down. Or, the most dramatic case that I myself have seen—after two years of online dating, a young woman suffers cardiac arrest after she and her family meet her boyfriend for the first time. Move over Manti Te’o—talk about Internet drama!

It turns out that the brain, the “fight or flight” nervous system, and the heart are all inextricably linked. Both when we get excited and when we become suddenly bereaved, our bodies produce hormones that then get dumped suddenly into the bloodstream in order to activate our bodies. In small doses, these hormones speed up the heart and make it beat harder. Think about the excitement before a big race, or a soldier before a battle. In small doses, these hormones are beneficial.

However, in sudden large doses, these hormones can “shock” the heart. The heart muscle can become so weak that it can’t pump enough blood to bathe the brain. This is very different from a traditional heart attack, which is caused by lack of blood flow to the heart. Broken heart syndrome is caused by the toxic effects of a tsunami of stress hormones.

Who gets broken heart syndrome?

Research shows that middle-aged or older women are more likely than others to get broken heart syndrome, probably because of the unique ways in which women’s bodies respond to stress. It may have to do with their decreasing levels of protective estrogen later in life. In any case, men make up less than 10 percent of these cases. This is unexpected, because men are more likely than women to get the traditional type of heart attack caused by blockage of the heart arteries.

How is broken heart syndrome diagnosed?

An important thing to remember is that broken heart syndrome is rare. Traditional heart attacks are common. So broken heart syndrome can never be diagnosed without first ruling out a traditional heart attack by checking the health of the heart arteries. After that, doctors can look for a particular pattern on an electrocardiogram (EKG) and echocardiogram that points to the diagnosis, and of course take a history to see if there has been emotional stress. It turns out that other stressors, such as other medical illnesses, can also lead to a version of broken heart syndrome.

Do patients with broken heart syndrome improve?

Broken heart syndrome can be fatal, but usually it’s not. If patients survive the shock, their hearts commonly return to normal over the course of several weeks. There is little evidence that doctors need to prescribe medications to start the recovery process, although a beta blocker might help.

Perhaps that is the lesson this Valentine’s season—almost all broken hearts will recover with time!

©1996-2013, Johns Hopkins University. All rights reserved. Disclosure: The information provided here is compiled by The Johns Hopkins University School of Medicine with editorial supervision by one or more of the members of the faculty of the School of Medicine pursuant to a license agreement with Yahoo! Inc. under which the School of Medicine and its faculty editors receive licensing fees and payment for services rendered within the scope of the License Agreement. Johns Hopkins subscribes to the HONcode principles of the Health on the Net Foundation.

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