Illustrated broken heart

It’s Not a Myth — A Broken Heart Can Be Fatal

February 10, 2022

Believe it or not, grief can be deadly. Broken heart syndrome — which is actually known as stress-induced cardiomyopathy or takotsubo cardiomyopathy — occurs when extreme emotional distress causes a normally healthy heart to fail temporarily. Though the condition can be fatal, the majority of people who experience broken heart syndrome seem to recover quickly.

First identified in 1991, broken heart syndrome isn’t as rare as it was previously thought to be, says Sachin Shah, MD, a cardiologist at Lahey Hospital & Medical Center. “It usually presents as the abrupt onset of chest pain and trouble breathing after significant emotional stress, such as after the death of a loved one or even a surprise birthday party. This can also be triggered by physiologic stress, such as with pneumonia or a seizure.”

What Does Broken Heart Syndrome Look Like?

Broken heart syndrome shares many symptoms with heart attacks which is why it’s often misdiagnosed. Both conditions can cause changes to the blood and heart rhythm as well as consist of difficulty breathing and sudden, intense chest pain (called angina).

The key difference between a heart attack and broken heart syndrome, however, is that individuals who suffer from broken heart syndrome tend not to show any evidence of blocked or clogged arteries — a common factor in heart attacks. Instead, the condition develops due to a sudden onset of stress hormones that weaken the heart and enlarge part of it. As a result, that area becomes difficult to pump with blood which causes the rest of the heart to work harder than usual. 

Similar to heart attacks, stress-induced cardiomyopathy can lead to irregular heartbeats (called arrythmias) or cardiogenic shock, a condition in which the heart is weakened and fails to pump enough blood to keep the body functioning properly. 

“Cardiogenic shock can be fatal if it isn’t treated quickly. It occurs in about 10 percent of patients with stress induced cardiomyopathy, based on an international registry. Cardiogenic shock occurs when the heart fails and cannot provide adequate blood flow to the other organs. Shock related to stress-induced cardiomyopathy is difficult to treat and almost half of the cases are fatal,” said Dr. Shah. “It’s the most common reason that people die of heart attacks, and it’s what makes broken heart syndrome potentially life-threatening. Anyone experiencing chest pain and shortness of breath needs medical attention and should call 911 right away.”

How Is a Broken Heart Diagnosed and Treated?

At this point, broken heart syndrome has only been a formally recognized medical diagnosis for three decades. However, thanks to thorough research, skilled cardiologists can usually differentiate between stress-induced cardiomyopathy and a heart attack. 

  • A person suffering from broken heart syndrome will show these signs:
  • An onset of symptoms following extreme emotional or physical stress
  • Labs and imaging tests that don’t show evidence of blocked or clogged arteries 
  • EKG tests, which measure the heart’s electrical activity, with results that differ from those experiencing heart attacks 
  • Imaging that shows enlargement and inadequate contraction in the lower left chamber of the heart
  • A much faster recovery time compared to that of a heart attack (days or weeks vs. months)

If you receive a stress-induced cardiomyopathy diagnosis, there’s a chance you might require medication to manage short-term effects. Currently, no long-term medical management strategy exists, but many patients who suffer from broken heart syndrome remain on medication, even after their heart function stabilizes. 

“There’s still a lot we don’t know for sure about this condition — from exactly what causes it, to how it affects the heart long-term,” said Dr. Shah. “But it’s safe to say that anyone who has experienced a major cardiac event should develop a relationship with a cardiologist and have routine checkups to ensure the heart recovers and continues to function properly.”

If you’re concerned about your heart health, don’t wait to speak to your primary care doctor or seek out a cardiologist.