Broken Heart Syndrome: Symptoms and Causes

What Is Broken Heart Syndrome?

Broken heart syndrome is a condition with symptoms that may feel like a heart attack, like chest pain, and shortness of breath, but it’s caused by going through an emotionally stressful event, not by clogged arteries.

It’s triggered by very stressful situations, like the death of someone you love.

Your doctor may call this stress-induced cardiomyopathy or takotsubo cardiomyopathy.

Broken Heart Syndrome Causes

It’s thought that when you have broken heart syndrome, your body releases stress hormones that temporarily curb your heart’s ability to pump as well as it should, and a part of your heart called the left ventricle temporarily weakens and stops pumping well. Experts also believe that your coronary arteries, which feed oxygen to your heart muscle, spasm. This can cause chest pain. The momentary “freezing” or “stunning” of your heart can bring circulation problems.

If broken heart syndrome is not treated, it can be as deadly as a heart attack.

Broken Heart Syndrome Symptoms

The most common signs are chest pain and shortness of breath. You may feel like you are having a heart attack. If you feel that way, call 911. You may also have:

• Dizziness or fainting
• Low blood pressure
• Nausea
• An irregular heartbeat

Usually symptoms start anywhere up to a few hours after you’ve had stress or shock.

Broken Heart Syndrome Triggers

Broken heart syndrome can be triggered by stressful emotional events, including good events, as well as bad ones, such as:

• The death of a loved one
• Surgery
• Serious illness
• Money problems
• Abuse
• Public speaking
• Losing your job
• Getting divorced
• Car accidents
• Emotional memories
• Winning the lottery
• Being the guest of honor at a surprise party

In rare cases, certain drugs may trigger broken heart syndrome, because they may cause hormones to surge in your body. Such drugs include:

• Epinephrine, which treats severe allergic reactions
• Duloxetine (Cymbalta), which can treat nerve problems among people with diabetes and is also an antidepressant
• Venlafaxine (Effexor XR), an antidepressant
• Levothyroxine (Synthroid, Levoxyl), which can treat thyroid problems
• Methamphetamine
• Cocaine

Broken Heart Symptom Risk Factors

Women are much more likely to have broken heart syndrome than men, especially women who are over 50. This could be a result of lower estrogen levels, but doctors aren’t sure. Common risk factors include:

• Being over 50 (for men and women)
• Genetics. Experts also believe that genes may make some people more likely to get broken heart syndrome.
• Having a head injury or seizure disorder like epilepsy
• Having a psychiatric disorder like anxiety or depression

You’re not more likely to get broken heart syndrome if you have a history of heart disease.

Broken Heart Syndrome Diagnosis

If your doctor thinks you might have it, several tests can help figure things out:

Physical exam and history. Your doctor will examine you and ask about your symptoms. They’ll want to know about any major events or stress you’ve had lately.

Electrocardiogram (ECG). Your doctor will do one of these to look for any problems with your heart’s rhythm and structure. The results will let them know if your symptoms are from a heart attack.

Blood tests. Many of them can show damage to the heart.

Coronary angiogram. This test looks at coronary artery disease. Dye is injected in your chest and your coronary arteries to help your doctor see any blockages. People with heart attacks usually have them. Folks with broken heart symptoms typically don’t.

Echocardiogram. This ultrasound shows your doctor if you have an enlarged heart or if your heart has an abnormal shape while it pumps. That last one can be a sign of broken heart syndrome.

Radionuclide perfusion imaging. A similar test to an echocardiogram, this helps show which areas of the heart muscles get blood normally through the coronary arteries. It also lets your doctor know where you could have heart damage.

Chest X-ray. This can show if you have an enlarged heart or if it has an abnormal shape. It can also help to see if lung problems are the cause of your symptoms.

Broken Heart Syndrome Versus Heart Attack

They may feel the same, but they’re different. Heart attacks are caused by blockages of waxy buildup within the arteries leading to your heart. With broken heart syndrome, there aren’t any blockages; the heart just doesn’t pump blood as well as it should, which causes heart attack-like symptoms. When treated, people should recover from broken heart syndrome more quickly than from a heart attack, because the heart isn’t damaged the same way.

Broken Heart Syndrome Treatment

Broken heart syndrome is treatable. Your doctor will prescribe medicines used to treat things like heart failure. For example:

• ACE inhibitors
• Angiotensin II receptor blockers (ARBs)
• Beta-blockers
• Diuretics (water pills)
• Anti-anxiety medication

These drugs can help your heart while it recovers.

Broken Heart Syndrome Complications

On rare occasions, people die from broken heart syndrome, but most people recover fully without any long-term effects. But it’s possible to have complications, such as:

• Heart valve damage
• Heart failure
• Low blood pressure
• Fluid backing up into your lungs
• An irregular or disrupted heartbeat

Broken Heart Syndrome Outlook

People who survive the initial stun to the heart typically get better within 4-8 weeks. Your doctor may order a test, such as an echocardiogram, after 6 weeks, to see if your heart has improved. Once you recover, your doctor may tell you that you can stop taking the medication that was prescribed for broken heart syndrome. This usually happens within 3 months of your initial diagnosis.