BROKEN HEART SYNDROME

1.  Is a broken heart real?

Broken heart syndrome is a temporary heart condition that’s often brought on by stressful situations and extreme emotions. The symptoms often mimic those of a heart attack such a sudden onset of chest pains.

The good news is that this is a reversible heart condition. Unlike a heart attack, broken heart syndrome happens when a sudden physical or emotional stress causes a rapid weakening of your heart muscle.

You may think you’re having a heart attack because symptoms, such as shortness of breath and chest pain, are similar in both conditions. However, in broken heart syndrome, you (for the most part) don’t have blocked coronary arteries or permanent heart damage, and usually make a fast and full recovery.

Broken heart syndrome is also called stress cardiomyopathy or Takotsubo cardiomyopathy. Takotsubo is the Japanese name for an octopus trapping pot with a wide bottom and narrow neck. The pot resembles the shape of the distressed left ventricle of the heart seen in broken heart syndrome.

Women are more likely than men to experience sudden, intense chest pain — the reaction to a surge of stress hormones — that can be caused by an emotionally stressful event. It could be the death of a loved one or a divorce, breakup or physical separation, betrayal or romantic rejection. It could even happen after a good shock, such as winning a big prize.

2.  What to look for: signs and symptoms

The most common signs and symptoms of broken heart syndrome are angina (chest pain) and shortness of breath. You can experience these things even if you have no history of heart disease.

Arrhythmias (abnormal heartbeats) or cardiogenic shock also may occur with broken heart syndrome. Cardiogenic shock is a condition in which a suddenly weakened heart can’t pump enough blood to meet the body’s needs, and it can be fatal if it isn’t treated right away. When people die from heart attacks, cardiogenic shock is the most common cause.

Add to that sweating and dizziness, and you may think you are having a heart attack. But the difference is that these symptoms may begin as soon as minutes or as long as hours after an emotionally or physically stressful event.

3.  What leads to broken heart syndrome?

The exact cause of broken heart syndrome is unclear. It’s thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn’t completely clear.

A temporary squeezing (constriction) of the large or small arteries of the heart may play a role. People who have broken heart syndrome may also have a change in the structure of the heart muscle.

Broken heart syndrome is often preceded by an intense physical or emotional event. For example, an acute illness (such as an asthma attack or COVID-19 infection), major surgery or a broken bone can lead to broken heart syndrome. Anything that causes a strong emotional response, such as a death or other loss, or a strong argument may trigger this condition.

Rarely, use of certain drugs may lead to broken heart syndrome, including:

• Emergency medications used to treat severe allergic reactions or severe asthma attacks
• Some medications used to treat anxiety
• Nasal decongestants
• Illegal stimulant drugs

We strongly advise that you need to tell your doctor about the medications you take, including those bought without a prescription. When starting a new medication, be informed about the potential risks and side effectsbefore taking any medications.

4.  How does it differ from a heart attack?

Unlike a heart attack, in broken heart syndrome your heart muscle is not permanently damaged and your coronary arteries are not blocked. 

Our team would order tests to help reveal if your symptoms are broken heart syndrome or a heart attack. You have broken heart syndrome and not a heart attack if: 

• Your symptoms appeared suddenly following a stressful physical or emotional event.
• Your EKG was abnormal – your heart’s electrical activity showed some abnormal changes – the changes are the same as those seen during a heart attack.
• Your blood work shows a rise in cardiac enzymes levels, the same enzymes that would be high in a heart attack.
• The arteries supplying your heart are usually not blocked and there’s no scar tissue present in your heart.
• The lower part of your left ventricle is enlarged – shows a ballooning of this area – and there’s unusual muscle wall movements.

5.  I have a broken heart – what is the treatment?

It is important to follow up with a cardiologist who is familiar with this syndrome and who can tell you when your heart muscle has fully recovered. Early on, the cardiologist may want to treat you with standard medications for heart muscle weakness, but this will depend on several factors including your heart rate and blood pressure.

Your doctor may suggest an exercise program including cardiac rehabilitation. Avoiding stressful situations if possible is always recommended, and interventions to reduce stress such as biofeedback, meditation, yoga, physical rehabilitation and exercise can be very helpful to some patients with this syndrome.

The team at German Heart Centre is certified and experienced to support the diagnosis of your symptoms.  Why not get in touch with your questions or to book a full physical check-up?

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information on the topic.