Is Broken Heart Syndrome Real?
Broken heart syndrome may sound like a curse suffered by characters in fairy tales, but it’s actually a very real and serious condition — though fortunately rare. Also known as Takotsubo cardiomyopathy or stress cardiomyopathy, broken heart syndrome causes heart attack symptoms in people experiencing a stressful event.
Amy Sarma, MD, a Mass General Brigham cardiologist, describes what to look out for and the importance of managing our response to stress. Dr. Sarma is co-director of the Corrigan Women’s Heart Health Program at Massachusetts General Hospital, where she treats patients with heart disease.
What are the causes and symptoms of broken heart syndrome?
“Broken heart syndrome, or Takotsubo cardiomyopathy, refers to development of temporary weakening of the heart muscle following either a very positive or very negative emotional or physically stressful event,” explains Dr. Sarma.
“Most commonly, heart imaging shows that the weakening of the heart muscle occurs in a specific pattern, though this is not always the case. The name Takotsubo cardiomyopathy arose because this classic pattern makes the heart look like a Japanese octopus fishing pot,” Dr. Sarma says. Additionally, the body releases enzymes that can be measured in blood tests. However, there are no blocked arteries like those seen in heart attacks caused by coronary artery disease.
“The exact cause of Takotsubo is still not well understood, but overall, the stressful emotional or physical event results in release of catecholamines (or adrenaline), which affects the heart muscle cells in a way that leads to the temporary weakening of the heart muscle,” says Dr. Sarma.
What are the symptoms of broken heart syndrome?
Symptoms very closely mimic a real heart attack, including:
Chest pain
A squeezing or tightening sensation in the chest
Shortness of breath
Sudden lightheadedness
Jaw, neck, arm, or back pain
Nausea
If you experience the sudden onset of any of these symptoms, call 911. Further testing is required to distinguish between a traditional heart attack and broken heart syndrome.
Who is at risk of broken heart syndrome?
“Anyone can experience broken heart syndrome, which can occur in either sex at any age,” says Dr. Sarma. “However, for reasons that are still not completely understood, it occurs most commonly among postmenopausal women.” Women who have gone through menopause have lower levels of the hormone estrogen, which may affect how stress impacts the arteries. More research is being done to understand the causes of broken heart syndrome and how it affects the body.
How is broken heart syndrome diagnosed?
Doctors may use these tests to check for broken heart syndrome:
Blood tests: Elevated blood enzymes, like troponin, are a sign of heart damage.
Electrocardiogram (EKG): This test measures the electrical signals of your heart.
Coronary angiogram or CT scan: Doctors use these tests to examine the heart’s blood vessels. Because broken heart syndrome presents with the same symptoms as a heart attack, it is important for doctors to ensure that you are not experiencing a traditional heart attack first.
Echocardiogram: This may reveal weakened heart function, often in a pattern consistent with Takotsubo cardiomyopathy
Be sure to mention to your providers if you’ve experienced a recent stressful event.
What is the treatment for broken heart syndrome?
“The good news is that heart function usually recovers after broken heart syndrome. Patients may require hospital treatment for fluid accumulation (or heart failure) because of weakened heart function, arrhythmias, and blood clots that can develop in the heart,” Dr. Sarma says.
Treatment can include medication, rest, and further monitoring. “Medications like beta blockers and either ace-inhibitors or angiotensin receptor blockers (which treat high blood pressure or heart failure) can be used. Other medications can also treat low heart function. With this treatment, the heart function usually returns to normal,” says Dr. Sarma.
“While rare, the syndrome can recur, so we encourage all patients to work on managing stress, particularly if that was a trigger for the syndrome,” Dr. Sarma says. Seeking support for anxiety and depression, starting a meditation practice, exercising regularly, and getting enough sleep are all ways to help reduce stress.
