Spotlight: What Really Happens During “Broken Heart Syndrome?
It can mimic a heart attack, but it’s really something completely different.
It’s called “stress cardiomyopathy,” or “broken heart syndrome.”
We’ve all heard of people having heart attacks after getting bad news. But
sometimes, bad news, or even something as seemingly happy as a surprise party,
can trigger a different kind of attack.
What happens during broken heart syndrome?
For some people, sudden, overwhelming emotional stress causes the release of the
hormones called “catecholamines,” most notably adrenaline and noradrenaline,
into the bloodstream. This can “stun” the heart muscle, diminishing its ability
to pump blood, and cause the typical symptoms of a heart attack, including chest
pain, fluid in the lungs and difficulty catching your breath.
Heart attacks occur when a blockage, usually a clot in the arteries,
interrupts blood supply to the heart. When people experience broken heart
syndrome, however, testing usually reveals no such blockage. Additionally,
during a heart attack, the heart muscle can become damaged, and when this
happens, enzymes are released into the bloodstream. People with broken heart
syndrome do not have these enzymes in their blood. And MRIs reveal that they
have not suffered any permanent muscle damage as a result of their attack.
Additionally, researchers found that people with broken heart syndrome had
catecholamine hormone levels that were two to three times higher than the heart
attack patients, and seven to 34 times higher than normal levels, another clear
sign that the problem was caused by stress.
Recovery quicker than after heart attack
Patients suffering from at attack of broken heart syndrome generally see an
improvement in their heart’s pumping ability within a few days. They’re usually
completely recovered within two weeks. On the other hand, people often need
weeks or months to recover from a heart attack, and muscle damage is often
What can cause broken heart syndrome?
In a recent study on broken heart syndrome, patients experienced symptoms after
such events as the death of a loved one, being the guest of honor at a surprise
party, having to speak in public, being the victim of an armed robbery,
appearing in court or being in a car accident. Most people who suffer from the
syndrome are women.
Researchers don’t yet know how catecholamine hormones act to stun the heart.
They also don’t know why more women are affected than men, nor do they know
whether there is a genetic component to the syndrome. But one thing is clear: if
you have heart attack symptoms and you have had a severe emotional shock, be
sure to tell your doctor about it. It’s important for the people who treat you
to know whether you’re actually having a heart attack or whether you’re
suffering from stress cardiomyopathy.
New England Journal of Medicine online, 9 February 2005; Johns
Hopkins Medicine Press Release, 9 February 2005.