What causes a broken heart?

A “broken heart” is not just a figure of speech. It really has literal meaning and a medical explanation behind it.

Researchers at the Johns Hopkins report about the so-called “broken heart” syndrome, which is a “real and potentially deadly” heart disorder. In doctor speak, it is called stress cardiomyopathy and occurs when “sudden emotional stress … results in severe but reversible heart muscle weakness that mimics a classic heart attack.”

A broken heart is therefore often misdiagnosed as myocardial infarction (heart attack). With this study results, it is hoped that doctors may be able to distinguish between a “heart broken” patient and a “heart attack” patient.

The researchers observed that

some people may respond to sudden, overwhelming emotional stress by releasing large amounts of catecholamines (notably adrenalin and noradrenalin, also called epinephrine and norepinephrine) into the blood stream, along with their breakdown products and small proteins produced by an excited nervous system. These chemicals can be temporarily toxic to the heart, effectively stunning the muscle and producing symptoms similar to a typical heart attack, including chest pain, fluid in the lungs, shortness of breath and heart failure.

The researchers observed that most broken hearted patients are women who are middle-aged and elderly and are basically very healthy and have low risk profile for cardiovascular disease. Diagnostics tests do not show any classical signs of cardiovascular problems, no blocked arteries, no elevated enzymes used as cardiac markers, and no damage to the heart muscles. However, the patients typically are suffering from some kind of sudden emotional stress – death in the family, a traumatic experience, a fear of something about to happen.

The stress proteins are highly elevated in broken-hearted patients, sometimes 3 to 4 times higher than what is measured in heart attack patients. The high concentrations of stress hormones cause cardiotoxicity and stun the heart, leading to abnormal heart contraction.

The good news is that, unlike the classical heart attack, a broken heart does not cause permanent damage to the heart and once the emotional stress is eased, recovery is quick.

Stressed patients showed dramatic improvement in their hearts’ ability to pump within a few days and had complete recovery within two weeks. In contrast, partial recovery after a heart attack can take weeks or months and, frequently, the heart muscle damage is permanent.

Hence, a broken heart is not just prose and poetry stuff. There is a science behind it and there must be some grain of truth when a person is said to have died of a broken heart. It happens a lot of times. Lifetime partners die within weeks or months of each other. Stress and anxiety can bring a person down.

In her book The Heart Speaks, cardiologist Mimi Guarneri tells us how emotional distress like grief, anger, and anxiety can indeed break our hearts and what we can do to mend it again.