Can You Really Die of a Broken Heart?

Few of us are strangers to having our hearts broken. Whether the cause is a breakup, crushed dream or death of a loved one, a broken heart inflicts a special kind of pain. It's considered an emotional state, but we allude to more than just our frame of mind when we describe it. We "feel it in our bones," say our chest hurts and call it heartbreak, after all. We explore the science of a broken heart — how it can physically affect the body and whether it can cause actual heart damage or even, in certain cases, death.

We asked Dr. Devang Parikh, Structural Interventional Cardiologist at Houston Methodist, seven questions and here are the answers to what you need to know about having a broken heart. 

Can heartbreak have physical effects on the body?

Yeah, absolutely. The actual name for what you're describing is something called Takotsubo Cardiomyopathy. And that was first identified in 1990 by Dr. Sato. And the reason he came to that wording is because when he took pictures of the heart with a catheter and some dye, what he noted is that it looked like an octopus trap that they use in Japan. And that's where the word stemmed from. But the actual diagnosis of it includes people that come in with pain that makes them feel like they're having a heart attack. And that's the challenge sometimes in the diagnosis of this condition. But they truthfully come in feeling like they're having an actual heart attack, and that's not actually what's going on.

Is broken heart syndrome an actual medical condition?

Yes, it’s an actual condition. It's an actual diagnosis.

Why can the syndrome be confused with a heart attack?

The symptoms are shortness of breath, nausea, sometimes people can pass out. They come in, their blood pressures are low, they're sweaty, they're clammy. And so, as an interventional cardiologist, you're all gearing up to go, you know, go fix whatever heart artery is blocked. And you get in there and you find all the heart arteries are completely fine. And so, then you're scratching your head kinda going, “Well, what's going on?” He's got, or she's got classic chest pain. The levels of the enzymes from the heart that would indicate damage to the heart are elevated, but I'm looking at these arteries and they look, you know, maybe better than mine. And that's when you start to put one and one together and go, “Oh, maybe there's something else going on.” And that's where this heartbreak syndrome is kind of been identified.

What are the emotional and physical triggers of broken heart syndrome?

Nothing pinpoints, which is the vagueness of this is the complexity of this. And the challenge of it as a patient and as a diagnostician. So, the triggers can be multitude of things. It could be losing a job, losing a loved one, getting a divorce, big things in your life, life-changing events. It could be having a stroke, it could be undergoing surgery, even an elective surgery. So, one of my patients was undergoing an elective nose surgery because they, you know, they were snoring a lot at night. And in recovering from that surgery, they ended up having this condition occur. So, it could be a multitude of things, whether it's physical or emotional. The physical triggers tend to be a little more common about 40% of the time. And then the emotional triggers tend to be about 30%. And then the remaining is more of like a combined picture where you get some physical and emotional issues. So, we'll see it in patients that have had like big car accidents or something like that.

Everyday heartbreak can affect the body, too

Broken heart syndrome is specifically a transient weakness of your heart muscle related to a physical or emotional trigger, that occurs outside of the presence of any heart artery disease. And so, it's an isolated event that triggered the surge of hormones that causes a weakening of the heart muscle. 

How common is broken heart syndrome and what is the prognosis?

We’re all susceptible to this. You just want to be aware. I think us as physicians, we want to be aware of that for our patients, but, you know, educating patients themselves is important. 

The long-term prognosis is very good. The identification of it has become a lot easier. And most patients, 95% of patients, recover full heart function within a matter of a few days to a matter of a few weeks. There may be a temporary period of time where you're on one or two medications and then you're off. But the important thing to know is that when you experience chest pain, shortness of breath, feeling like something is wrong and you're just not quite yourself. Those are times to seek out medical care. 

How can your doctors help unravel heartbreak syndrome's root cause?

Cardiologists are trying to put one and one together. It's only since the nineties that we have become more attuned to the fact that emotional and physical things that happen in our day-to-day life can have such dramatic impacts on the heart itself. And so, now we're paying more attention to it. We're trying to identify what causes it in a little bit more detail, because that still remains a bit of a mystery. We've been trying to identify some of these triggers, and then obviously the more important thing is, you know, how you're gonna manage it and how are you gonna recover from it.

A reminder of why it's important to have great relationships with your doctors. Untreated it can be dangerous. And so, have a good relationship with your doctors. Seek them out if you feel like something is wrong, and just know that there's a good prognosis at the end of this if you take good care of yourself.

February 2023