Can You Die From a Broken Heart?

My wife lost her first love recently. Preceding me by five years, this guy was a constant presence in her house when we met. He shared her bed. He slept on her sofa. He ate her food. Even when I cast questioning glances his way during the early days of our courtship, nothing changed. I soon learned that his presence was just part of the package. So when her feline friend died last week, the sadness that rippled through our house caused many broken hearts. The emotions doused our kids like an afternoon thunderstorm, flooding their young lives with a cathartic grief that soon passed. But for their middle-aged parents, the puddles of sadness have not evaporated. Too much history, I suppose, and too many memories to remind us of what has been lost.

Coinciding with the cat’s death came an article out of Europe reminding us of the effect that sadness and grief—or any emotional stress—can have on the heart. We’ve long known that those with cardiac concerns are vulnerable to depression. This recent scientific report, though, highlighted the other side of that emotional equation in describing the electrical changes that influence a broken heart.

In the early 1990’s, investigators in Japan [1] published their findings of a group of five patients who had all the symptoms of a heart attack but did not have the tell-tale blockages of the coronary arteries. These patients shared a common dysfunction of the left ventricle. Rather than tightly stretching and forcefully contracting with each heart beat, the ventricles of these patients dilated like a kid’s balloon with each pump, reminding the Japanese investigators of an octopus trap. The patients with the octopus-trap heart also shared a common feature of their medical history: grief. Whether from emotional or physical sources, their hearts could not handle the stress and collapsed into an ineffective state soon-to-be named ‘Takotsubo Cardiomyopathy.’ In the years that followed, investigators across the globe began to recognize more cases of this ‘Broken Heart Syndrome,’ with the unique triad of clear coronary arteries, ineffective ventricular pumping, and a history of acute stress.

Which brings us to our current situation.

The European investigators [2] looked at the typical symptoms of the Broken Heart syndrome—symptoms of chest pain and shortness of breath, signs of ECG and lab abnormalities [3]—to try and find a way to detect those at risk for an added electrical problem. What they found when they looked back at 105 patients was that those with a broken heart and an electrical problem usually experienced more shortness of breath, suffered more severe pumping failure, and more often needed cardiac intensive care. In spite of near total shut down of the heart, though, these patients recovered. If given enough time, the cardiac problems, like the grief itself, will tend to improve.

To be sure, the majority of patients who experience the stresses of life will never have the elephant-like pressure of a heart attack nor will they suffer the octopus-trap ballooning of their left ventricle. But like a good poker player, patients can rest more comfortably with their odds if they know when to be worried. Don’t ignore heart pain that won’t remit. Don’t blame anxiety for unrelenting shortness of breath. When experiencing the sad side of love, pay attention to new or different symptoms in the chest.

When the cat died in January, our sadness was not from surprise [4]. And best we can tell, we are bruised but not broken. However, when mourning comes, we all could stand to pause for a moment and listen to our hearts.