By Vivek Sailam, MD, Cardiologist — Virtua Cardiology

You’ve probably read stories like this. A long-married husband and wife die within hours of each other, their love so great that they are unable to live apart.

Is it possible to die from grief?

Yes, but not usually. Broken heart syndrome—also called stress-induced cardiomyopathy or takotsubo (the Japanese name for an octopus pot that resembles the left ventricle) cardiomyopathy—is a condition in which intense emotional or physical stress can cause rapid and severe heart muscle weakness.

Cases of stress-induced cardiomyopathy are on the rise, especially in women ages 50 to 74, according to a recent study published in the Journal of the American Heart Association. Incidences have particularly gone up since the start of the COVID-19 pandemic.

Broken Heart Breakdown

During an episode of stress-induced cardiomyopathy, portions of the left ventricle temporarily enlarge and stop pumping effectively. The rest of the heart continues to function normally or even with more forceful contractions.

The condition can be mistaken for a heart attack, as there are similar symptoms, including chest pain, shortness of breath and low blood pressure. Tests may show changes in rhythm and blood substances that are typical of a heart attack, but the arteries are not blocked.

As you can’t tell whether you are having a heart attack or stress-induced myopathy, it is vital to seek emergency treatment. Under the care of an experienced cardiac team, most people with stress-induced cardiomyopathy make a full recovery within weeks, with no long-term heart damage.

Mind-Body Connection

Broken heart syndrome is triggered by a physical or emotional event, such as the death of a loved one, a medical diagnosis, losing or winning money, a surprise party, or sustaining an injury.

A surge adrenaline and other stress hormones overwhelm and “stun” the heart. The arteries narrow, leading to a temporary decrease in blood flow to the heart. Adrenaline also may bind to the heart cells, causing a large amount of calcium to enter the cells and not function properly.

While chest pain and shortness of breath are the most common symptoms, some people may also experience irregular heartbeats (arrhythmias), heart failure, or cardiogenic shock. Cardiogenic shock occurs when a suddenly weakened heart cannot pump enough blood to meet the body's needs.

If the heart isn't pumping effectively, blood inside of it can become stagnant and clot, greatly increasing the risk of stroke. All of these conditions can be fatal if not treated immediately.

Who's at Risk?

So why doesn’t everyone who has something stressful happen to them experience broken heart syndrome?

You need other risk factors that make your cardiovascular system vulnerable to spike in adrenaline, such as high cholesterol and high blood pressure.

Both men and women can get broken heart syndrome. Most cases, however, are in middle-aged and older women. It’s not clear whether hormone changes occurring during perimenopause and menopause play a role.

Regardless whether it is stress-induced cardiomyopathy or a heart attack, if you experience symptoms like chest pain or shortness of breath, call 911 right away and get immediate medical attention. When it comes to your heart, every minute counts.

Advanced Heart Care Right in Your Neighborhood

Virtua’s team of more than 100 cardiac experts provides comprehensive care, from medical cardiology to interventional procedures to advanced cardiac surgery. Appointments are available within 48 hours. Schedule an appointment with a Virtua cardiologist now.