Overview

Broken heart syndrome is a temporary heart condition that's often brought on by stressful situations and extreme emotions. The condition can also be triggered by a serious physical illness or surgery. It may also be called stress cardiomyopathy, takotsubo cardiomyopathy or apical ballooning syndrome.

People with broken heart syndrome may have sudden chest pain or think they're having a heart attack. Broken heart syndrome affects just part of the heart, temporarily disrupting your heart's normal pumping function. The rest of the heart continues to function normally or may even have more forceful contractions.

The symptoms of broken heart syndrome are treatable, and the condition usually reverses itself in days or weeks.

Symptoms

Broken heart syndrome symptoms can mimic a heart attack. Common symptoms include:

  • Chest pain
  • Shortness of breath

Any long-lasting or persistent chest pain could be a sign of a heart attack, so it's important to take it seriously and call 911 if you experience chest pain.

When to see a doctor

If you're having any chest pain, a very rapid or irregular heartbeat, or shortness of breath after a stressful event, call 911 or emergency medical assistance immediately.

Causes

The exact cause of broken heart syndrome is unclear. It's thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn't completely clear.

A temporary constriction of the large or small arteries of the heart has been suspected to play a role. People who have broken heart syndrome may also have a difference in the structure of the heart muscle.

Broken heart syndrome is often preceded by an intense physical or emotional event. Some potential triggers of broken heart syndrome are:

  • The death of a loved one
  • A frightening medical diagnosis
  • Domestic abuse
  • Losing — or even winning — a lot of money
  • Strong arguments
  • A surprise party
  • Public speaking
  • Job loss or financial difficulty
  • Divorce
  • Physical stressors, such as an asthma attack, a broken bone or major surgery

It's also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include:

  • Epinephrine (EpiPen, EpiPen Jr.), which is used to treat severe allergic reactions or a severe asthma attack
  • Duloxetine (Cymbalta), a medication given to treat nerve problems in people with diabetes, or as a treatment for depression
  • Venlafaxine (Effexor XR), a treatment for depression
  • Levothyroxine (Synthroid, Levoxyl), a drug given to people whose thyroid glands don't work properly
  • Unprescribed or illegal stimulants, such as methamphetamine and cocaine

How is broken heart syndrome different from a heart attack?

Heart attacks are generally caused by a complete or near complete blockage of a heart artery. This blockage is due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis) in the wall of the artery. In broken heart syndrome, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.

Risk factors

There are a number of known risk factors for broken heart syndrome, including:

  • Sex. The condition affects women far more often than men.
  • Age. It appears that most people who have broken heart syndrome are older than 50.
  • A history of a neurological condition. People who have neurological disorders, such as a head injury or a seizure disorder (epilepsy) have a greater risk of broken heart syndrome.
  • A previous or current psychiatric disorder. If you've had disorders, such as anxiety or depression, you probably have a higher risk of broken heart syndrome.

Complications

In rare cases, broken heart syndrome is fatal. However, most people who experience broken heart syndrome quickly recover and don't have long-lasting effects.

Other complications of broken heart syndrome include:

  • Backup of fluid into your lungs (pulmonary edema)
  • Low blood pressure (hypotension)
  • Disruptions in your heartbeat
  • Heart failure

It's also possible that you may have broken heart syndrome again if you have another stressful event. However, the odds of this happening are low.

Prevention

Broken heart syndrome sometimes happens again, though most people won't experience a second event. Many doctors recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart. Recognizing and managing stress in your life also may help prevent broken heart syndrome, though there's currently no evidence to prove this.

Nov. 14, 2019
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