Can you really die of a broken heart? Yes, although it is very unlikely. The correct term for this condition is stress cardiomyopathy. It is also known as broken heart syndrome, takotsubo cardiomyopathy, and apical ballooning syndrome. As trivial as ‘broken heart syndrome’ might sound, this is in fact a potentially life-threatening condition.
Cardiomyopathy refers to rapid and severe weakness in the heart muscles. Stress cardiomyopathy, as you might infer, is when this condition is caused by extreme stress. In other words, we are talking about stress induced cardiomyopathy.
The Causes of Stress Cardiomyopathy
Extreme stressors, either emotional or physical, can cause this condition. Some examples of emotional and environmental stressors are:
- Frightening medical diagnosis
- Significant financial loss
- Public performance
- Domestic abuse
- Natural disasters
- Losing your job
Possible physical causes of stress cardiomyopathy include:
- Significant bleeding
- Asthma, emphysema, or other breathing difficulties
- Car accident
- Major surgery
The Symptoms of Stress Cardiomyopathy
The symptoms of this condition are very similar to those of a heart attack. They often arise quite quickly and suddenly. These symptoms include:
- Chest pains
- Difficulty breathing
- Nausea and vomiting
- Heart palpitations
- Low blood pressure
- Congestive heart failure
So if you are wondering “Can stress cause chest pain?” the answer is yes. There is a very real link between stress and chest pain. In fact, chest pain from stress is one of the defining features of stress cardiomyopathy.
The Difference Between Stress Cardiomyopathy and a Heart Attack
Although both a heart attack and stress cardiomyopathy share similar symptoms, these two conditions have different causes. They also have different effects on your heart.
During a heart attack, heart cells are actually killed. During stress cardiomyopathy, on the other hand, the heart cells are temporarily stunned by adrenaline and other hormones in your system.
When your body experiences stress – either emotional or physical – it releases proteins and hormones to assist you in coping with the stress. One of these hormones is adrenaline. When large amounts of adrenaline are suddenly produced, the heart is overwhelmed and heart cells are stunned.
When this occurs your heart becomes misshapen. Both a heart catheter and an ultrasound will reveal a balloon effect on your heart. This explains the link between chest pains and stress.
Fortunately, this does mean that with stress cardiomyopathy you stand a good chance of full recovery without suffering any permanent damage to your heart – a very different result to that following a heart attack.
Even if you experience stress cardiomyopathy and have extreme heart muscle weakness when you are admitted to hospital, the good news is that your ‘stunned’ heart cells will improve rapidly – within a few days or weeks. In the majority of cases, the heart recovers completely within a few weeks without any permanent damage to the heart.
Who is at Risk for Stress Cardiomyopathy?
Stress cardiomyopathy is experienced more often by women. In fact, women are eight to nine times more likely to experience this condition than men. The average age of those who experience this is 60 years old.
Overall, the vast majority of people who experience stress cardiomyopathy seem to be post menopausal women. This is thought to be because after menopause women have lower levels of estrogen, which would ordinarily protect the heart against stress hormones.
Further research needs to be conducted in order to determine other risk factors. There is some evidence that a history of depression as well as your personality and genetic makeup might put you at risk for experiencing stress cardiomyopathy.
The Treatment for Stress Cardiomyopathy
Because the difference between a heart attack and stress cardiomyopathy are not immediately evident due to their similar presentation, many patients who are admitted to hospital with stress cardiomyopathy are in fact treated as having a heart attack.
In fact, about 2% of all patients who are thought to be suffering from a heart attack are in fact experiencing stress cardiomyopathy. This figure increases to 5 to 7% in the case of female patients. It is hoped that as more is learnt about stress cardiomyopathy, so doctors will be better able to distinguish between these two conditions.
The treatment for stress cardiomyopathy typically consists of supportive care whilst your heart muscles regain their strength and your blood pressure improves. This supportive treatment can take the form of:
- Medication to remove fluid from your lungs
- Medications to improve your blood pressure
- Prevention of blood clots and strokes with the use of blood thinners
- Very ill patients might require a ventilator or an intra-aortic balloon pump to temporarily help the heart pump blood
It is likely that you will be hospitalized until you have made a complete recovery.
The Prognosis and Recurrence of Stress Cardiomyopathy
Given the information above, the prognosis for patients with stress cardiomyopathy is excellent. In the case of this condition, the effect of adrenaline on the heart is temporary and generally completely reversible. It is only in rare cases that stress cardiomyopathy is fatal.
Encouragingly, only 5 to 10% of patients will experience a recurrence of stress cardiomyopathy, even if they experience subsequent stressors in their lives.
In other words, preventative measures should be put in place. These generally include:
- Eat a healthy, balanced diet
- Learn to recognize the causes and presence of stress in your life
- Practice stress management techniques
- Exercise regularly
- Nurture supportive relationships and develop a support network
- Practice meditation