Overview

Broken heart syndrome, also known as stress cardiomyopathy or Takotsubo cardiomyopathy, is a heart condition triggered by stressful situations, extreme emotions, serious physical illness, or surgery. Although often temporary, some individuals may experience ongoing symptoms even after the heart has healed.

Broken heart syndrome affects only part of the heart, causing a brief interruption in its normal pumping function. The rest of the heart continues to work as usual, and sometimes the heart contracts more forcefully during this condition.

Symptoms

The symptoms of broken heart syndrome can mimic those of a heart attack and may include:

  • Chest pain
  • Shortness of breath

If you experience persistent chest pain, rapid or irregular heartbeat, or shortness of breath, seek immediate medical attention as these symptoms could be indicative of a heart attack.

Causes

The exact cause of broken heart syndrome is not entirely understood, but it is believed to involve a surge of stress hormones, such as adrenaline, that may temporarily damage the heart in some individuals. It is also possible that a temporary squeezing of the heart’s arteries or changes in the heart muscle’s structure play a role in the condition’s development.

An intense physical or emotional event, such as sudden illness, major surgery, broken bones, loss of a loved one, or a strong argument, can trigger broken heart syndrome. Additionally, certain drugs, including emergency medicines for severe allergic reactions or asthma attacks, some anxiety medications, and illegal stimulants like methamphetamine and cocaine, have been linked to the syndrome in rare cases.

How is broken heart syndrome different from a heart attack?

Unlike heart attacks, which are usually caused by complete or near-complete blockage of a heart artery, broken heart syndrome does not involve blocked heart arteries. However, blood flow in the heart arteries may be reduced during the condition.

Risk Factors

Risk factors for broken heart syndrome include being female, age over 50, and a history of anxiety or depression.

Complications

Most individuals recover quickly from broken heart syndrome without lasting effects. However, some may experience recurrent episodes of the condition, known as recurrent takotsubo cardiomyopathy. In rare cases, broken heart syndrome can be fatal.

Potential complications of broken heart syndrome include pulmonary edema (fluid backup into the lungs), low blood pressure, irregular heartbeats (arrhythmias), heart failure, and blood clots in the heart.

Prevention

Long-term treatment with beta blockers or similar medications is often recommended to prevent another episode of broken heart syndrome. These medicines can block the harmful effects of stress hormones on the heart.

Managing emotional stress is crucial in preventing broken heart syndrome. Strategies to reduce and manage stress include engaging in regular exercise, practicing mindfulness, and connecting with others through support groups.

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Diagnosis

Broken heart syndrome is usually diagnosed in an emergency or hospital setting because its symptoms can mimic those of a heart attack. To diagnose broken heart syndrome, your healthcare provider will examine you, ask about your symptoms and medical history, and inquire about any recent major stresses, such as the death of a loved one.

Tests used to diagnose broken heart syndrome include:

  • Blood tests to check for elevated levels of cardiac enzymes
  • Electrocardiogram (ECG or EKG) to measure the heart’s electrical activity
  • Coronary angiogram to rule out blockages in the heart arteries
  • Echocardiogram to create images of the heart using sound waves
  • Cardiac MRI to create detailed images of the heart using magnetic fields and radio waves

Treatment

There is no standard treatment for broken heart syndrome, but initial care is similar to that provided for a heart attack. Most people with broken heart syndrome stay in the hospital while they recover.

Medications may be given to reduce strain on the heart and prevent further episodes. These medications may include:

  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Beta blockers
  • Diuretics
  • Blood thinners, if there is a blood clot

Surgeries or procedures used to treat a heart attack are not helpful for broken heart syndrome, as this condition does not involve blocked arteries.

Preparing for Your Appointment

If you suspect you have broken heart syndrome, seek medical attention in an emergency or hospital setting. If possible, have a family member or friend accompany you to the hospital to help remember important information. Before your appointment, be prepared to provide your symptoms, recent major stresses, personal and family medical history, and a list of medications you take. Don’t hesitate to ask any questions during your appointment.

What to Expect from the Doctor

During your appointment, your healthcare provider will likely ask about your symptoms, when they started, any associated pain or discomfort, family history of heart problems, and any other health conditions you may have or are being treated for.

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