What Is Broken Heart Syndrome?

A broken heart may be a metaphor, but acute emotional or physical stress can result in broken heart syndrome, a real medical condition that’s growing in prevalence. Also called stress cardiomyopathy or Takotsubo cardiomyopathy, it can look and feel like a heart attack, but the causes and symptoms differ in important ways.

“Takotsubo cardiomyopathy is a condition in which cardiac function is transiently impaired, causing shortness of breath, chest pain, and/or abnormal rhythm,” says cardiology researcher Antonio Abbate, MD, PhD, a professor at the University of Virginia School of Medicine. “It’s not caused by a heart attack, an infection, or a toxic effect on the heart but rather from an abnormal brain-heart connection, often related to a psychological or physical stressor.”

These stressors may include feelings of grief, fear, anger, or surprise, writes cardiologist Ilan Wittstein, MD, of the Johns Hopkins School of Medicine.

Physical stressors may include high fever, a stroke or seizure, blood loss, difficulty breathing, such as with an asthma attack or emphysema, or extremely low blood-sugar levels.

Incidence of stress cardio­myopathy is on the rise due to increased awareness, recognition, and imaging, Abbate says. Still, he cautions in one study that “the condition is likely underdiagnosed,” so “the true incidence is unknown.”

Stress can cause your body to produce adrenaline and noradrenaline, and the flood of these hormones can overwhelm the heart muscle. It may also result in a “temporary decrease in blood flow to the heart,” Wittstein writes. In other cases, adrenaline can bind to heart cells, preventing the heart from beating properly.

A genuine heart attack “is caused by a blockage in the flow in one of the arteries feeding the heart, which impairs heart function, can cause abnormal rhythm, and leaves a scar in the heart,” explains Abbate. “Takotsubo is not caused by blockages; it also impairs heart function and causes abnormal rhythm, but when it resolves it leaves no scar.”

Broken heart syndrome is usually short-term and reversible, Abbate and Wittstein note. Still, Abbate says more research is needed to determine how one incident may affect patients in the long term and whether it leaves them more suscep­tible to another attack.