Broken heart syndrome: Is bad news bad for your heart?

Your grandmother learns her husband has passed away and immediately begins complaining of chest pain. This sort of reaction — experiencing chest pain or a heart attack after hearing bad news — is sometimes shown in television and movies. But it's not just fiction. Some people seem to actually get symptoms mimicking a heart attack after hearing bad news or experiencing other types of stress, a phenomenon doctors now refer to as broken heart syndrome.

First described medically in 1991 by Japanese doctors, the condition was originally called takotsubo cardiomyopathy. Takotsubo is a type of pot used by Japanese fishermen to capture octopuses. When doctors take images of a person who's experiencing broken heart syndrome, part of his or her heart resembles the pot. Today, the condition is also referred to as stress cardiomyopathy, stress-induced cardiomyopathy or apical ballooning syndrome. Much about broken heart syndrome is a mystery.

What causes broken heart syndrome?

It's thought that a surge of stress hormones, such as adrenaline, might temporarily damage the heart of some people. How these hormones might hurt the heart or whether something else is responsible isn't clear.

What we do know is the onset of broken heart syndrome is often preceded by an intense physical or emotional event. Some of the triggers of broken heart syndrome have included news of an unexpected death of a loved one, a frightening medical diagnosis, domestic abuse or losing a lot of money. Physical stressors, such as an asthma attack or car accident, also have been known to trigger broken heart syndrome.


Is broken heart syndrome harmful?

In rare cases, those with broken heart syndrome can die of the disorder. However, most people who experience broken heart syndrome quickly recover and don't suffer long-lasting effects.


Who is at risk of broken heart syndrome?

We don't know why, but broken heart syndrome affects women far more often than men. Some research indicates nearly 9 out of 10 cases occur in women, and of those, almost all are in women 50 or older.


What are the symptoms of broken heart syndrome?

Broken heart syndrome can mimic a heart attack, with common symptoms being chest pain or shortness of breath. Any persistent chest pain could be a sign of a heart attack, so it's important you take it seriously and call 911 if you experience chest pain.


How is broken heart syndrome treated?

There are no standard treatment guidelines for treating broken heart syndrome because of the limited knowledge about the condition. Initially, it's treated similar to a heart attack until the diagnosis is clear. There is no specific therapy, and most people recover spontaneously. Your doctor might prescribe diuretics (water pills), vasodilators or beta blockers. Diuretics and vasodilators may not be required long term, because heart function usually returns to normal. The duration of beta blockers treatment is unknown; however, these medications might prevent recurrent attacks. Many people with broken heart syndrome are hospitalized for suspected heart attack, and the diagnosis of broken heart syndrome is often made in the hospital. Most people are hospitalized for a week or so.


How is broken heart syndrome different from a heart attack?

Most heart attacks are caused by a complete blockage of a heart artery due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis). In broken heart syndrome, the heart arteries are not blocked, although blood flow may be sluggish.

Coronary angioplasty and stent placement are commonly used for treatment during a heart attack, but these procedures are not helpful in broken heart syndrome since there is no blockage.


Can broken heart syndrome recur?
Possibly. Some of our research indicates broken heart syndrome can occur multiple times in about 10 percent of those affected by broken heart syndrome.


By Charanjit Rihal, M.D., a cardiologist and director of Mayo Clinic's Cardiac Catheterization Laboratory