Broken heart syndrome, also called stress-induced cardiomyopathy or takotsubo cardiomyopathy, is a temporary heart condition that’s often brought on by stressful situations and extreme emotions. The condition can also be triggered by a serious physical illness or surgery. It may feel like a heart attack, but it’s not a heart attack.
What are the symptoms of broken heart syndrome?
The main symptoms of broken heart syndrome are:
- Chest pain
- Shortness of breath
- Irregular heartbeat
Other symptoms may include:
- Anxiety
- Sweating
- Lightheadedness
- Nausea
The symptoms of broken heart syndrome are similar to those of a heart attack. The difference is that with broken heart syndrome, there’s rarely any permanent damage to the heart.
What causes broken heart syndrome?
Experts don’t know exactly what causes broken heart syndrome, but it’s thought to be linked with the body’s physical response to emotional stress. Intense emotions like grief, anger, and fear flood the body with stress hormones like adrenaline and cortisol. This can temporarily damage the hearts muscle cells or cause spasms in the heart’s blood vessels.
Possible triggers for broken heart syndrome include:
- Bereavement – for example, after the loss of a loved one
- Divorce or relationship problems
- Serious illness or surgery
- A frightening medical diagnosis
- Domestic abuse
- Asthma attack
- Car or other accident
- Job loss or financial problems
- Natural disasters like earthquakes
In some cases, there’s no clear trigger. The condition may occur spontaneously.
Why is it called broken heart syndrome?
Broken heart syndrome was first recognized in Japan in the early 1990s. Doctors noticed the condition in people who’d experienced sudden heart attacks after emotionally stressful events. The Japanese called it takotsubo cardiomyopathy, after the octopus traps that the heart chambers resemble in this condition.
The condition was brought to international attention in 1998 after doctors at Johns Hopkins School of Medicine studied people with sudden heart failure following acute emotional stress. It became known as broken heart syndrome due to its link with bereavement, breakups, and other emotional triggers.
Who’s at risk of broken heart syndrome?
Broken heart syndrome mainly affects women over 50 years old, but it can also occur in:
- Younger women
- Men
- Children
Other risk factors include:
- History of anxiety, depression, or other psychiatric disorders
- Neurological and cerebrovascular disorders like stroke
- History of cancer
Having a history of heart disease doesn’t seem to raise the risk.
How is broken heart syndrome diagnosed?
If a doctor suspects broken heart syndrome, they’ll do some tests to confirm the diagnosis. These may include:
- Electrocardiogram (ECG) – This records the heart’s electrical activity and can show abnormal heart rhythms.
- Echocardiogram – An ultrasound scan of the heart that shows how well the heart chambers and valves are working.
- Blood tests – To check for heart muscle damage and rule out a heart attack.
- Coronary angiogram – This uses X-rays and a special dye to check the heart’s blood vessels for blockages.
These tests can show characteristic signs of broken heart syndrome, including:
- Enlarged heart with a balloon-like appearance of the left ventricle
- Problem with heart motion and pumping
- Normal coronary arteries with no blockages
- Changes in heart rhythm
The results help rule out a heart attack, which causes permanent damage, unlike broken heart syndrome.
What is the treatment for broken heart syndrome?
The treatment focuses on supporting the heart while it recovers and managing symptoms. It may include:
- Medications – Such as ACE inhibitors, beta blockers, diuretics, and anti-anxiety drugs.
- Follow-up testing – To check recovery of the heart’s pumping ability.
- Treatment for complications – For example, heart failure or pulmonary edema.
- Psychological support and counseling – To help deal with stress triggers and underlying mood disorders like depression.
Most people make a full recovery within a few weeks. But in rare cases, broken heart syndrome can cause severe, long-lasting damage to the heart.
What’s the outlook for people with broken heart syndrome?
The outlook for broken heart syndrome is generally very good. The vast majority of people who experience it make a full recovery within a few weeks.
With appropriate treatment and follow-up, most people can expect a full recovery within:
- 1 to 4 weeks – Recovery of the heart’s squeezing ability
- 2 months – No symptoms or physical limitations
Complications are quite rare, but they can include:
- Recurrence – Around 10% of people have broken heart syndrome again.
- Heart failure – If extensive heart muscle is damaged.
- Blood clots – These can increase the risk of stroke.
- Death – This affects around 5% of people. It’s most common in the first few days after diagnosis.
Addressing emotional and psychological triggers may help lower the risk of recurrence. Ongoing follow-up with a doctor is important, even after recovery.
Key points about broken heart syndrome
- Broken heart syndrome temporarily weakens the heart muscle in response to intense emotional or physical stress.
- Its main symptoms are chest pain and shortness of breath. It can feel like a heart attack.
- The condition mostly affects older women but can also occur in men and younger people.
- Diagnostic tests like ECGs and echocardiograms help rule out a heart attack.
- Treatment focuses on heart support and managing symptoms while the heart recovers.
- The outlook is generally very good, with most people making a full recovery within weeks.
Conclusion
In summary, broken heart syndrome is a temporary condition where extreme emotion causes temporary heart muscle weakness or spasms in the heart’s blood vessels. While it can feel like a heart attack, there is no permanent damage to the heart. With the right diagnosis and treatment, most people recover fully within weeks.
