A medical phenomenon known generically as stress cardiomyopathy was discovered in 1990 by a Japanese cardiovascular specialist. It’s still known in some parts of the world as takotsubo (“octopus pot”) cardiomyopathy.
Most of us, however, know it as broken heart syndrome. But is it really possible to die of a broken heart?
Medical evidence suggests yes. This rarely invoked syndrome generated considerable attention in late 2016 when actress Debbie Reynolds, 84, died a day after the death of her actress-author daughter, Carrie Fisher (“Star Wars”), 60.
Reynolds’ death seemed to fit much of the criteria: a postmenopausal woman who suffers intense emotional (or physical) stress that causes severe heart muscle weakness (cardiomyopathy) in the heart’s left ventricle. Women between the ages of 58 and 75 have accounted for more than 90 percent of reported cases.
But most people recover, quickly, with no lasting effects on the heart.
Symptoms
Stress cardiomyopathy can feel very much like a heart attack, with chest pain, low blood pressure, difficulty breathing and congestive heart failure. These symptoms can appear only minutes after severe stress -- even if the person has no history of heart problems. An electrocardiogram, a test that measures the electrical activity of the heartbeat, might even show the same abnormalities as a heart attack.
Here’s the difference: Unlike a heart attack, there are no indications of blocked heart arteries with stress cardiomyopathy.
Causes
Researchers have targeted sudden, extreme stress – whether the death of a loved one, an asthma attack, an argument, even a surprise party or public speaking – as the main cause of stress cardiomyopathy. It also has been linked to depression and other mental health diseases.
Although researchers still have not determined an exact cause, the most plausible explanation starts with a sudden surge of adrenaline or other stress hormones. These hormones shock the heart into changes in coronary blood vessels or heart muscle cells that stop the left ventricle’s normal contractions.
Treatment
It’s not a heart attack, but doctors often treat stress cardiomyopathy patients with heart-failure medications:
- ACE inhibitors: Lower blood pressure.
- Angiotensin receptor blockers: Lower blood pressure by relaxing blood vessels.
- Beta blockers: Slow heart rate, lower blood pressure.
- Isosorbide dinitrate/hydralazine hydrochloride: Relaxes blood vessels, making it easier for the heart to pump blood.
- Diuretics: Reduce fluid buildup in lungs and associated swelling in ankles and feet.
- Digoxin: Strengthens the heart, allowing it to pump more blood.
People rarely die from stress cardiomyopathy. More likely, symptoms last anywhere from one to four weeks. Because the heart muscle is not damaged permanently, most people are back to normal within two months.
There’s also little evidence a single episode of stress cardiomyopathy makes you vulnerable to another – even if you experience severe stress again.