Broken Heart Syndrome: Stress Really Can Break Your Heart

Facing a divorce or a loved one’s death can cause you to feel heartbroken. Severe emotional stress can also cause real heart damage — broken heart syndrome.

Being frightened or experiencing anxiety over something you dread can make your heart pound, possibly trigger palpitations, and raise your blood pressure. Those symptoms are common and normal physiological responses to stress that usually pass quickly.

But the sudden shock from severe emotional stress can affect your cardiovascular system more seriously. The result can be Takotsubo syndrome (TTS), better known as broken heart syndrome.

Broken heart syndrome can be a tragic example of how your mind and emotions can wreak havoc on your heart. When someone says they feel like they are “dying from a broken heart” because of their suffering after a personal loss, that statement can sometimes be true.

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Broken heart syndrome risks and symptoms

In 1990, Japanese scientists were the first to identify TTS, also identified as takotsubo cardiomyopathy. Sudden, extreme stress triggers the potentially fatal condition. For example, it can develop within hours after a person learns a spouse or child has died. Severe physical stress, such as being lost in rugged terrain or enduring a lengthy combat situation, can also cause TTS.

Researchers believe that broken heart syndrome rapidly damages your heart because stress hormones flood your body during times of intense shock. The process can stun and weaken the heart muscle even in people who are perfectly healthy. One of the heart’s lower chambers, the left ventricle, then balloons outwards.

The resulting symptoms can include:

• Chest pain
• Low blood pressure
• Shortness of breath
• Potentially fatal abnormal heart rhythms
• Rapidly developing heart failure

The good news is that the condition is often temporary. It can usually be treated, and most people respond well and recover from TTS quickly, often within several weeks.

It’s important to talk to you doctor if you have experienced a severe shock and are not feeling well. Never ignore any physical symptoms after a particularly stressful time in your life because, although it’s rare, people can die from broken heart syndrome, according to the American Heart Association.

The brain and heart connection in broken heart syndrome

Scientists at Harvard-affiliated Massachusetts General Hospital (MGH) have uncovered more clues about how broken heart syndrome develops. A study by the MGH researchers, published in the European Heart Journal, found a strong link between how your brain responds to stress and whether you are likely to the condition.

Some people appear to be primed to develop broken heart syndrome after stressful events that others might not consider very stressful at all. What’s more, the stress may not involve the typical heartbreaking event most patients who develop broken heart syndrome report.

For their research, the investigators analyzed brain imaging scans from 104 patients who had the tests for medical reasons not connected to broken heart syndrome. The goal was to document whether the people with scans that showed increased stress-associated metabolic brain activity had been more likely to eventually develop TTS.

In all, 41 of the research subjects developed TTS and 63 did not. The researchers found a strong link between those people whose brain scans showed a heightened brain activity associated with stress and broken heart syndrome occurrence.

“Areas of the brain that have higher metabolic activity tend to be in greater use (in people who develop TTS). Hence, higher activity in the stress-associated centers of the brain suggests that the individual has a more active response to stress,” explained senior author Ahmed Tawakol, MD, director of Nuclear Cardiology and co-director of the Cardiovascular Imaging Research Center at MGH.

“We show that TTS happens not only because one encounters a rare, dreadfully disturbing event — such as the death of a spouse or child, as the classical examples have it. Rather, individuals with high stress-related brain activity appear to be primed to develop TTS and can develop the syndrome upon exposure to more common stressors, even a routine colonoscopy or a bone fracture,” said cardiologist Tawakol. 

In addition, the researchers found a relationship between stress-related brain activity and bone marrow activity. Several different types of blood cells needed to carry oxygen, launch immune responses, and clot blood are made in your bone marrow. The MGH scientists concluded stress-related brain activity may negatively affect the production of those cells and, in turn, impact heart health.

The bottom line, according to Tawakol, is that more studies are needed to find ways to lower stress-related brain activity to lower broken heart syndrome risk. Learning more about the impact of stress reduction — or drug interventions targeting stress-related brain activity — on heart health are also important, he added.

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