The next time someone says a broken heart won't kill you, correct them — a September 2015 study published in the New England Journal of Medicine (NEJM) proves otherwise. Researchers found broken-heart syndrome — yes, it's a thing! — can actually lead to death.
The condition was typically thought of as an old wives' tale, but the way it affects the heart is very real.
When broken-heart syndrome — more formally known as as stress-induced cardiomyopathy or takotsubo cardiomyopathy — occurs, the heart contracts to the extent that it changes shape and looks more like a pot (hence "takotsubo," which is the Japanese word for the pot-like trap fishermen use to catch octopuses).
The condition is much more complicated than an octopus trap, though.
"In broken-heart syndrome, part of your heart temporarily enlarges and doesn't pump well, while the rest of your heart functions normally or with even more forceful contractions," says Johanna Paola Contreras, MD, MSc, FACC, assistant professor of cardiology at The Zena and Michael A. Wiener Cardiovascular Institute at Mount Sinai.
There are physical triggers of broken-heart syndrome, including intracranial bleeding and epilepsy, but it's most often been associated with emotional triggers.
"Broken-heart syndrome is due to an acute neurohormonal activation that can happen as a reaction to an emotionally stressful event," Dr. Contreras says. "It could be the death of a loved one, a bad divorce, a breakup or physical separation, betrayal or romantic rejection. It could even happen after a positive shocking event like winning the lottery."
In the NEJM study, an international team of researchers reviewed records of 1,750 patients with broken-heart syndrome in nine different countries. Of the diagnosed patients, a whopping 90 percent ended up being postmenopausal women.
Why women are more likely to have the condition is unclear, but some think it could be that women have a lower threshold for that kind of stress stimulation.
"[Women] are thought to be more susceptible to intense emotional upset as a result," Contreras says. "Personally I think that's a very sexist explanation, though — the real answer is we honestly don't completely know yet."
After comparing patients with broken-heart syndrome to similar patients with acute coronary syndrome — which causes the same chest pressure felt during a heart attack — the researchers found something interesting: Emotional triggers were less common than physical triggers for broken-heart syndrome patients, with 27 percent having emotional triggers, 36 percent having physical triggers and 28 percent showing no clear trigger at all.
That said, while the syndrome may not have been triggered by emotional stress for many patients, more than half of the patients did have a history of either a neurological or psychiatric disorder.
The researchers also found that the long-term death rate for patients was about 5 percent each year. So although broken-heart syndrome can kill, most patients survive.
"With standard medical therapies and rest, most broken-heart syndrome patients recover and the heart muscle returns to normal," Contreras says.
Pay Attention to Your Heart
So what does this mean for you and your heart? Contreras says it's better to be safe than sorry when it comes to your heart health, and she recommends seeking immediate medical attention and a consultation with your physician if you're experiencing any of these symptoms:
- Severe chest pain
- Pain that feels like it originates from behind the breast bone
- Any type of chest pressure
- Difficulty breathing
- Irregular or racing heartbeats
- Dizziness or fainting in the face of severe emotional stress