The Science Behind Broken Heart Syndrome

The Science Behind Broken Heart Syndrome

It might feel like a heart attack, but broken heart syndrome is far from it.

Following the death of her beloved pet, Joanie Simpson, a 62-year-old from Texas, woke up with a serious backache and chest pain. She assumed she was having a heart attack. After being airlifted to a hospital in Houston, a cardiologist administered a coronary angiogram, or a special type of X-ray, to determine if the patient had blocked arteries. Her results came back clean.

After further testing, doctors diagnosed her with takotsubo cardiomyopathy, also known as broken-heart syndrome. Simpson acknowledged that the death of her Yorkshire terrier caused her extreme distress and likely triggered the cardiomyopathy.

Simpson was released from the hospital after two days, and a year later hasn’t had any further symptoms. But we can’t help but wonder how emotional stress can cause a broken heart.

What is stress?
Stress is the body’s reaction to a challenge or demand placed on it. It’s a broad definition, and just about anything can be a stressor, such as job loss, a car accident, being the victim of a crime or the death of a loved one.

When you experience stress, the body releases a number of hormones that make your muscles tense up, heart beat faster and lungs take in more oxygen, among other effects.  That’s good when you have to fight off or escape from danger, but in the modern world, stress is often of a non-physical nature and operating your body in a red-line state can cause serious health problems.

Acute stress is stress that disappears quickly. A crying baby can stress you out, but the stress disappears when the baby quiets down. Chronic stress, like the stress of a long-term illness or unhappy marriage, doesn’t go away so easily. Chronic stress can cause anxiety, hypertension, insomnia, a weakened immune system and a host of other problems.

Stress and broken heart syndrome
Stress—particularly chronic stress—is especially dangerous to the cardiovascular system. Severe emotional stress can also cause a condition called broken heart syndrome. This medical condition also called a stress cardiomyopathy or takotsubo cardiomyopathy, mimics many symptoms of a heart attack, and is often brought on by severe emotional or physical stress.

Most people recover fully, though a 2015 study found that 7 percent experienced serious complications such as stroke. Unlike a heart attack, tests will show no or very little signs of damage to the heart or a blood clot blocking any coronary arteries. An electrocardiogram (EKG) of a stress cardiomyopathy will look different than an EKG of a heart attack.

In addition to raising heart disease risk factors, stress can directly cause more serious heart problems like stroke. One large study in older adults found that the risk of stroke and heart attack was more than doubled in the 30 days after a spouse’s death.

Another study found that people with the highest chronic stress scores were 59 percent more likely to have a stroke or transient ischemic attack (TIA) than the people with the lowest stress scores. Additionally, the most depressed people were 89 percent more likely to have a stroke or TIA than the least depressed, and the most hostile were more than twice as likely to have a stroke or TIA than those with the least hostility.

Your best defense against stress
One of the best ways to relieve stress and help your heart at the same time is exercise. A 2013 study of more than 27,000 people published in Stroke found that physical inactivity was associated with a 20 percent increase in stroke risk. Exercise is a helpful stress reliever because it reduces stress hormones and releases endorphins, the body’s natural painkillers and mood elevators.

The Centers for Disease Control and Prevention recommends at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise. Find out how stress might be aging you by taking the RealAge test, which measures how your family history and health habits, like proper stress management, affect your longevity.

Medically reviewed in January 2020.

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