Checking into Heartbreak Motel: Broken Heart Syndrome
Can you die from a broken heart? You may be surprised
Posted Feb 14, 2018
Valentine’s Day can be a day to celebrate love, a day to dwell on being single or just another day of the week. It really is what you make of it, however there will be many individuals going through the motions of Valentine’s Day with a broken heart and studies have shown that many relationships end right around this day of the year. Therefore for many, after V-Day comes D-Day as newly single individuals check into Heartbreak Motel.
Can you die from a broken heart?
“You can die of a broken heart — it's scientific fact — and my heart has been breaking since that very first day we met. I can feel it now, aching deep behind my rib cage the way it does every time we're together, beating a desperate rhythm: Love me. Love me. Love me.”
— Abby McDonald, Getting Over Garrett Delaney
For many of us who have had our hearts broken, it can physically hurt. Heartbreak is real and in medicine, broken heart syndrome, is a physiologic condition that mimics a myocardial infarction aka heart attack. Takotsubo cardiomyopathy (TCM) was first described in 1990. A significant emotional (an unexpected death of a loved one, a divorce, bad financial news) or physical stressor (motor vehicle collision, significant surgery, a stay in the intensive care unit [ICU]) typically precedes the development of TCM in two-thirds of patients; thus, the condition is also known as "broken heart syndrome."
Broken heart vs. heart attack
Patients with broken heart syndrome share similar signs and symptoms as those presenting with a myocardial infarction (heart attack), such as crushing chest, pain, ST-segment elevation on electrocardiography (ECG), and elevated cardiac enzyme markers on lab results. However, when the patient undergoes cardiac angiography, left ventricular (LV) apical ballooning is present, as opposed to significant coronary artery stenosis, which is seen in myocardial infarctions. In other words, results on cardiac angiography differentiate acute myocardial infarction (heart attack) from broken heart syndrome, as treatment and morbidity drastically differ between the two conditions.
Left ventricular ballooning refers to a boggy left ventricle because the muscle is weakened. Think of a plastic grocery bag floating in the water. The Japanese word takotsubo translates to "octopus pot," resembling the shape of the left ventricle during systole on imaging studies. The left ventricle is responsible for pumping out oxygen rich blood to the entire body and therefore when this heart muscle becomes weak, the body can be deprived of oxygen, resulting in strain on the heart. As a reaction to emotional or physical stress, the body’s natural response is to release catecholamines aka stress hormones that temporarily stun the heart muscle.
Risk factors for broken heart syndrome
Learning of a death of a loved one
Bad financial news
Motor vehicle collisions
Exacerbation of a chronic medical illness
Newly diagnosed, significant medical condition
Intensive care unit (ICU) stay
Use of or withdrawal from illicit drugs
Treatment for broken heart syndrome
Individuals with broken heart syndrome are admitted to the hospital and are closely monitored for any further signs of infarction or heart failure. Most people who experience it make a full recovery within weeks, and they’re at low risk for it happening again.