Can You Die of a Broken Heart?

Broken heart syndrome may often be confused with symptoms of a heart attack.

From the WebMD Archives

Lisa Wysocky was having a bad week even before she landed in the emergency room one afternoon in July 2009.

The previous day she had learned that her adult son, Colby, had died of an overdose after struggling with mental illness. She then spent the night on her bedroom floor with pain that she suspected was from a heart attack. But she was too numb with grief to seek help immediately.

Once the Nashville, Tenn., resident went to the hospital, doctors began running tests. They told Lisa that instead of a heart attack, she actually had a different type of heart problem called stress cardiomyopathy. This problem -- which is also dubbed "broken heart syndrome" -- may be the real issue in some cases that initially appear to be a heart attack.

Understanding broken heart syndrome requires understanding how the body reacts to stress -- and a bit of knowledge about Japanese octopus-fishing gear.

A Troubled Mind May Lead to a Broken Heart

The term "broken heart syndrome" came about after researchers noticed that many people with the condition were grieving, says Ilan Wittstein, MD, a Johns Hopkins University cardiologist who's been studying the condition for a decade.

"The first several patients we saw, many of them had [just experienced] the death of a loved one, a spouse, a parent. Some people started having symptoms at a funeral," he tells WebMD.

But other patients had just gone through a trauma like a car accident or a mugging. Another woman landed in the intensive care unit on her 60th birthday after being startled by well-wishers shouting "Surprise!" Wittstein says.

These types of events can trigger your sympathetic nervous system, which is also called your "fight or flight" mechanism, says Peter Shapiro, MD, a professor of clinical psychiatry at Columbia University who studies emotional issues in heart disease.

Your body unleashes a flood of chemicals, including adrenaline, he says. This sudden flood can stun your heart muscle, leaving it unable to pump properly.

So even though broken heart syndrome may feel like a heart attack, it's a very different problem that needs a different type of treatment.

Continued

The Shape of a Broken Heart

Broken heart syndrome has yet another name: Takotsubo syndrome.

A tako-tsubo is a pot that's used in Japan for catching sea creatures. When Japanese researchers looked at images of people's hearts during broken heart syndrome, they noted that the left ventricle had taken on an unusual shape resembling the fishing pot.

During an episode of the condition, the heart muscle can be so profoundly affected that it can't pump blood out to the body strongly enough. As a result, the patient may develop heart failure. This can be life-threatening, Wittstein says.

The symptoms are so similar to those of a traditional heart attack that you, a paramedic, and even many ER doctors aren't going to know the difference, Wittstein says. They include:

Because traditional heart attacks can be triggered by stress as well, you shouldn’t take any chances.

"If you're at home having chest pain, you shouldn't question whether this could be stress cardiomyopathy just because you're going through a stressful period. The take-home message is get to the hospital and let the doctors find out which one of these you’re having," Wittstein says.

Diagnosing a Broken Heart

Clues that may help lead your doctor to the right diagnosis are your age and gender. More than 90% of cases reported thus far have been in women.

It's especially common after menopause. Lisa Wysocky was 52 when she had her encounter with broken heart syndrome.

Some research suggests that about 2% of people who seem to be having a heart attack actually have broken heart syndrome. Among women, the number may be higher than 5%, Wittstein tells WebMD.

If you've just gone through grief, stress, or emotional trauma, mention it to your doctor, Wittstein says. Also bring up recent physical stress such as an asthma flare-up or low blood sugar, he says. These can also trigger the problem.

To diagnose broken heart syndrome, doctors usually perform an angiogram. This provides images of the major blood vessels that supply your heart. During a heart attack, one or more arteries are often blocked. But during broken heart syndrome, these blood vessels look OK.

Your doctor is likely going to want to also perform an echocardiogram. This takes pictures of your heart, which may reveal the tell-tale fishing pot shape.

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A Healed Heart

A remarkable aspect of broken heart syndrome is that "someone can be critically ill on a Monday, and by Thursday can literally be preparing to go home," Wittstein says.

Their heart muscle also usually recovers fairly quickly. Neither is often the case after a major heart attack.

Afterward, people may need to take heart medications called beta blockers or ACE inhibitors for a limited time. However, experts don't know if these drugs are necessary for the long term, Wittstein says.

Since her episode, Lisa hasn't had any more heart problems, and she's only taking a low dose of an anti-anxiety drug. These days, she spends her time authoring books, helping people with disabilities ride horses, and leading a foundation in Colby's name. She's grateful that her doctors were able to diagnose her condition as a short-term problem.

"What was so reassuring to me was that the doctor didn't dismiss the symptoms just because I wasn't having a heart attack. He understood my symptoms were real. That was very comforting to me," she says.

WebMD Feature Reviewed by Elizabeth Klodas, MD, FACC on January 24, 2011

Sources

SOURCES:

Lisa Wysocky, Nashville, Tenn.

Ilan Wittstein, MD, assistant professor of medicine, Johns Hopkins Medicine, Baltimore, Johns Hopkins Heart & Vascular Institute.

Peter Shapiro, MD, professor of clinical psychiatry, Columbia University, New York.

Nykamp, D. The Annals of Pharmacotherapy, March 2010; vol 44: pp 590-593.

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