The High Price of a Broken Heart

But you need not be fighting fires or averting potential airline collisions to damage your heart. Burnout—emotional exhaustion, physical fatigue, and cognitive weariness—can set in if a job is always stressful or intense, or if you've just been doing it for too long.

The destructive power of burnout is shocking. While it's been traced to psychological problems in the past, says Samuel Melamed, an epidemiologist at the Sackler School of Medicine at Tel Aviv University in Israel, only recently has it been recognized as a risk to the heart. In fact, Melamed has found that people who are burned out have a two- to-threefold higher risk of heart problems, including recurrent myocardial infarction, stroke, coronary-bypass surgery, increase of coronary atherosclerosis, and cardiac death. What's more, the possibility of damage done to the heart by burnout can last up to eight years after that boring or stressful job has come to an end. "The risk is equal to or exceeds that conferred by age, body mass index, smoking, blood pressure, or lipid levels," Melamed says.

Why is burnout so ruinous to the heart? Melamed theorizes that sleep deprivation and physical exhaustion are at the root. He has found that burned-out workers are uncomfortably restless and tense at work. After work, they are so irritable they can't unwind, leaving them sleep-deprived and so exhausted that they become overwhelmed by fatigue.

Sudden Shock: The Cost of Grief and Loss

Her husband died suddenly on a September evening in 1993, and a few hours later she was admitted to an emergency room in Rennes, France. The woman, 70, suffered intense, constrictive chest pain along with sweating, nausea, and vomiting; then she passed out. A couple of years later another woman, age 50, showed up at the same ER in Rennes. Her symptoms were similar and her story also marked by grief: Her son had taken his life just hours before. Both women were treated and both survived—but oddly, in the months thereafter, showed no signs that their heart tissue had been damaged or that they suffered coronary artery disease at all.

Such cases have long puzzled doctors, but in recent years the mystery has been solved. The phenomenon, often provoked by sudden stress or shock like the death of a loved one, causes symptoms that look like a garden variety heart attack, including shortness of breath and chest pain, fluid in the lungs, and, finally, perhaps heart failure. The heart's ability to pump is severely impaired, but the heart tissue itself isn't damaged, nor are the arteries clogged, as is often the case with cardiovascular disease. Instead, as the patient's grief takes hold the apex of the heart, which pumps blood to the left atrium, balloons out and weakens, resulting in abnormal blood flow. Not surprisingly, broken heart is now medically known as apical ballooning syndrome, or stress-induced cardiomyopathy.

"We're recognizing broken heart syndrome with greater frequency here in the U.S.," says Mayo Clinic cardiologist Chet Rihal, who has led the largest review of the condition to date. "This is different than chronic stress, where a person has trouble at work or at home. These mental and physical stresses tend to be caused by severe and sudden shock."

Rihal theorizes that extreme stress might kick up a flood of adrenaline, damaging tiny blood vessels and causing the heart's muscles to shut down. Some people appear especially susceptible: About 10 percent of broken heart patients will have a similar attack again.

Research connecting emotional health and heart health is still in the early stages, but the take-home message is clear: Safeguarding the heart can be as simple as walking away from a fight, quitting a boring job, or working out anger by running around the block. These simple, proactive interventions—if tapped regularly—just might save your life.