How Stress Can Break Your Heart—Literally

Dr. Ilan Wittstein, MD, a cardiologist at Johns Hopkins Hospital, in Baltimore, once had a middle-aged patient who discovered that her husband was cheating on her. Shortly after a heated argument over the infidelity, the woman began to experience shortness of breath and a crushing chest pain. Although it felt like a heart attack, it wasn’t. Quite literally, the woman was suffering from a broken heart.

Officially known as takotsubo cardiomyopathy, broken heart syndrome is a rare heart condition with symptoms that can mimic those of a heart attack.

“A lot of people experiencing the death of a loved one have this condition,” says Dr. Wittstein. “That’s why we nicknamed this broken heart syndrome.”

First described in Japanese medical literature in 1990, takotsubo cardiomyopathy takes its name from a vase-shaped pot, used to trap octopus in Japan, “that has a thin neck and balloons out where the body of the octopus gets stuck,” explains cardiologist Richard Stein, MD, a professor at the New York University School of Medicine, in New York City.

In broken heart syndrome, the bottom of the heart temporarily balloons out and resembles the shape of the traps, says Dr. Stein, who is also a spokesman for the American Heart Association.

Broken heart syndrome is most common among women (especially white women who have gone through menopause), and people who have depression or anxiety.

Though broken heart syndrome remains relatively rare, the number of people experiencing it appears to be on the rise, says Dr. Wittstein. He estimates that 2% of all people thought to be having a heart attack actually have broken heart syndrome. Among postmenopausal women, the figure could be as high as 5% to 7%, he says.

Takotsubo cardiomyopathy stuns the heart
Although they aren’t certain, experts believe takotsubo cardiomyopathy is triggered by adrenaline and other hormones that flood the body in response to a stressful event, be it the death of a loved one, the loss of a job, a mugging, or even walking in to your surprise birthday party.

“Any kind of sudden stress response can cause weakening of heart muscle, whether it’s sudden fear—someone holding a gun to your head—or the distress your body goes through in the middle of a bad infection or stroke,” says Dr. Wittstein.

Stress is involved in 9 out of 10 cases of broken heart syndrome, Dr. Wittstein adds—including that of the betrayed woman.