The Broken Hearted:

A Closer Look at this Real Condition

When someone experiences a tragic loss, it’s often said they have a “broken heart”. There is some truth to this metaphor. Broken Heart Syndrome is a real medical condition that’s triggered by stress and frequently mistaken as a heart attack. Doctors call it stress-induced cardiomyopathy, a rare condition that causes a sudden decrease in the pumping function of the heart. The good news is, it’s easily treated, so dying from a broken heart will likely only remain a metaphor.

For more on the causes and symptoms of this condition, we turned to our expert Angela M. Taylor, MD, MS, Co-Director of the UVA Diabetes Cardiovascular Center.

What causes stress-induced cardiomyopathy aka Broken Heart Syndrome?

It often occurs during stressful situations, which can be either emotional or physical. The physiological triggers of stress-induced cardiomyopathy are not completely understood. Several causes have been proposed, including spasm of the coronary arteries (arteries around the heart), sudden increases in catecholamines (adrenaline) that may occur in stressful situations, dysfunction in the very small vessels of the heart, or infections of the heart muscle that can sometimes be caused by viruses.

Who might be at risk?

This can happen to anyone but is most common in post-menopausal women.

Does this typically occur in people who have existing heart conditions or can it also occur in those who are healthy? 

It appears that the condition can occur in people with or without other heart conditions. Initially, this condition was defined in people with no coronary artery disease (blockages in the coronary arteries) and no other heart problems. However, we recently published a paper showing that this condition can occur in the presence of coronary artery disease. It is not clear if coronary artery disease is related to the condition. 

What are the signs/symptoms? 

They can be similar to symptoms of a heart attack or heart failure. These can include chest pain or shortness of breath. 

How is the condition treated? 

The condition is typically not life threatening and complete recovery of ventricular (pumping) function is expected. The condition is treated supportively. Sometimes this may mean only watching the patient in the hospital and starting medications to help with heart failure. For more serious cases, this may include intravenous medications to help with the pumping function of the heart, or an intra-aortic balloon pump. This is a device placed through the leg into the large artery (aorta) in the center of the body. It helps with the pumping function of the heart. Most people with this condition completely recover within six weeks. 

Can stress affect heart health in other ways? 

Stress can also contribute to coronary artery disease (blockages in the heart arteries) and hypertension (high blood pressure). 

What tips do you give patients for reducing stress? 

We encourage patients to participate in a regular exercise program.  Exercise is a healthy way to reduce stress and help the body form its own chemicals that fight stress. Yoga is also a helpful meditative way to lower stress. Focusing on establishing good life coping mechanisms is also beneficial.