Broken Heart Syndrome – How Even a Healthy Heart Can Break After Valentine’s Day

by Leigh on February 19, 2013

broken heart syndrome

It is possible to die of a broken heart – usually only in 1-3% of cases, however.

February 14th can be a tough day for many, with couples often feeling pressured to make things perfect and singles feeling obligated to find a date. Knowing that you’re quite unlikely to die of a broken heart is probably little consolation but even those with so-called Broken Heart Syndrome (Takotsubo cardiomyopathy) have a good prognosis generally.

Takotsubo cardiomyopathy is called Broken Heart Syndrome because it is associated with some kind of stressful trigger prior to onset. This could be the death of a loved one, the loss of a job, financial distress, a natural disaster, or a break-up. These significant emotional stressors create a short-lived cardiac syndrome that looks very similar to acute coronary syndrome and may cause confusion amongst physicians examining a patient with no clear risk factors for heart disease. This temporary weakening of the myocardium (the heart muscle) can cause distortion and enlargement of the heart; swelling that is quite unlike that heartburst upon falling in love, perhaps.


Symptoms of Takotsubo Cardiomyopathy

The left ventricle of the heart stops functioning properly, suffering akinesis (temporary paralysis) in Takotsubo cardiomyopathy (TCM), creating a characteristic enlargement visible on diagnostic scans. Patients usually present with check pain, dyspnea (shortness of breath), nausea and vomiting and palpitations. Upon questioning, it is often found that those with TCM have incurred some recent significant traumatic upheaval; around two-thirds of patients have such emotional triggers for TCM. Unlike acute myocardial infarction (heart attacks) and other acute coronary incidents which tend to occur early in the morning, Broken Heart Syndrome peaks in the afternoon, when more stressful events occur.

Causes of Broken Heart Syndrome

The possible mechanism behind this association of emotional stress with a ‘broken heart’ is the release of catecholamine in response to the stress. This then causes cardiotoxicity and stuns the myocardium, leading the heart to become partially paralysed. This alters the heart’s rhythm, creating visible signs on an electrocardiogram (ECG), and the patient may have low blood pressure because the blood flow is obstructed as the heart remains dysfunctional. Palpitations, dizziness, shortness of breath and nausea are all then likely to occur without treatment.

Treating a Broken Heart

Luckily, time really is a healer for the broken-hearted and most patients have few traditional risk factors for heart disease, meaning that they recover quickly. Hypertension, problematic lipid (fat) profiles, diabetes, a family history of heart disease and smoking are all connected to increased incidence of cardiovascular disease but patients suffering from TCM have a lower incidence of these and tend to respond well to emotional and psychological support with some medications necessary in some cases. Beta blockers may be helpful for some sufferers of Broken Heart Syndrome and a small number (around 5%) of patients benefit from anticoagulant therapy as they develop a left ventricular thrombus (blood clot)


Recovering from Broken Heart Syndrome

Around 95% of patients recover from a ‘broken heart’ within four to eight weeks with some 3% having another episode of the condition. Follow-up care is recommended to check cardiac function, with annual assessments the usual approach. Death from a broken heart (TCM) is thought to occur in 1-3% of patients, with a 20% complication rate, including heart failure, blood clot formation, rupturing of the ventricle wall, and problems with the heart maintaining its rhythm and proper blood flow. In December 2016, actress Debbie Reynolds died of what some suspect is broken heart syndrome, following the loss of her daughter, Star Wars actress and author, Carrie Fisher.

Stress has a serious effect on the body, with Broken Heart Syndrome perhaps the most significant acute consequence. Recovering from a break-up is hard enough, so ensure you look after your heart so it’s in fine fettle when you next give it away.

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