What Becomes of The Broken Hearted?

By Rosemarie Tracy, RN, BSN  /  February 3, 2025

Did you ever wonder if you could die of a broken heart?  Strong emotions such as grief, anger, fear, or excitement can affect your well-being.

Heartbreak is expressed through fine art on screen, stage, and literature, as well as through music, painting, and sculptures. The fine arts often explore the highs and lows of relationships, hardships, illness, loss, and grief and the devastating impact it has on the human spirit. Many movies, paintings, and literature come to mind, reminding us that heartbreak’s timeless rendezvous with humanity is epic and spans centuries. Heartbreak is a very real and profound part of the human experience. But did you ever think there was an actual physiologic response? Art tells us so and scientists are studying the effects of a broken heart on the brain, neurologic system, and the heart itself.

What Is Broken Heart Syndrome?

There are growing bodies of evidence pointing to what types of events may cause Broken Heart Syndrome. Studies show the risk of cardiovascular events increases in patients with a history of social isolation, marital and work stress, childhood abuse, and past trauma.

Broken Heart Syndrome or takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy is a temporary heart condition that mimics the signs and symptoms of a heart attack. It is characterized by a sudden and temporary weakening of the heart muscle, typically triggered by severe emotional or physical stress.

The condition was first described in Japan in the 1990s. It was named after the Japanese word for an octopus trap, “takotsubo”. The left ventricle (the main pumping chamber of the heart) in its normal state, is described as conical and likened to the shape of a bullet. In broken heart syndrome, during systole, (contraction) the left ventricle takes on the unique shape of an octopus trap or takotsubo. 

What Are the Symptoms?

Symptoms of Takotsubo cardiomyopathy (TCM) include chest pain, shortness of breath, and an irregular heartbeat. A surge of stress hormones, such as adrenaline, temporarily stuns the heart and impairs its function. Takotsubo cardiomyopathy can develop in men and women of any age and ethnic background. However, about 90% of those affected are women, and 80% are women over the age of 50.  Especially post-menopausal women, suggesting the role of estrogen deficiency. When men are afflicted with TCM, they tend to have a worse prognosis.

Patients with certain psychiatric conditions or mood disorders are also more likely to have takotsubo syndrome. Reports have also described patients developing takotsubo syndrome after a positive emotional experience known as Happy Heart Syndrome!

Common Triggers

Although roughly about a quarter of patients have no clear triggers, takotsubo syndrome is typically triggered by an unexpected emotionally or physically stressful event.

Events that have been reported to trigger TC include:

  • Domestic abuse or relationship conflict
  • Sudden loss of a loved one
  • Natural disasters
  • An accident or major trauma
  • A fierce argument
  • Severe financial or gambling losses
  • An unexpected surprise like winning a lottery
  • Being diagnosed with a serious acute medical condition or medical illness such as a stroke or a terminal illness
  • Exhausting physical effort
  • Surgery
  • Head trauma
  • Public speaking
  • Extreme fright
  • Use of drugs such as cocaine, excessive stimulant use, or inadvertent overdose of catecholamines
  • Drug withdrawal

The symptoms of takotsubo syndrome can look and feel like a heart attack and include:

·      Sudden, severe chest pain

·      Shortness of breath

·      Irregular heartbeat

·      Low blood pressure

·      Heart Palpitations

·      Fainting

Keep in mind that heart attacks are caused by a clot in a coronary artery. Broken heart syndrome is caused by a super surge in hormones released during the sympathetic nervous system’s fight or flight response that stuns the heart, causing abnormal pumping function. Stunning the heart triggers changes in the cardiac myocytes (cells) and coronary perfusion or blood flow through the heart muscle. When a patient presents to the hospital with symptoms, they are treated emergently, until a diagnosis is made.

Diagnosis of takotsubo cardiomyopathy involves ruling out other potential causes of the symptoms, such as a heart attack or coronary artery disease. Tests such as electrocardiograms (ECG), echocardiograms, cardiac MRI scans, or cardiac catheterization may be used to assess heart function and rule out other conditions.

Can You Mend A Broken Heart?

Once the diagnosis of takotsubo cardiomyopathy is made, a treatment plan typically consists of supportive care to manage symptoms, including rest and medications to reduce the workload on the heart and prevent complications such as heart failure or arrhythmias. Most cases of takotsubo cardiomyopathy resolve within days to weeks, with the majority of patients experiencing a full recovery. In some cases, complications such as heart failure or life-threatening arrhythmias may occur. The good news is, this type of heart failure is usually reversible and most people recover fully with appropriate medical treatment.

In rare cases, takotsubo cardiomyopathy can lead to severe complications such as arrhythmias, heart failure, or even death, particularly if it’s not promptly diagnosed and managed.

Complications of takotsubo cardiomyopathy include:

 ·     Low blood pressure

·      Arrhythmias or irregular heartbeats

·      Heart failure

·      Blood clots in the heart

·      Pulmonary edema or fluid in the lungs

However, the overall prognosis is generally good, and the majority of individuals who experience takotsubo cardiomyopathy recover completely without long-term consequences.

Anyone with symptoms related to a cardiovascular event such as chest pain, shortness of breath, or palpitations should seek medical attention immediately for proper diagnosis and treatment.

Pub Med Central. Psychological Stress as a Risk Factor for Cardiovascular Disease: A Case-Control Study.  Published, October 1, 2020. Accessed, February 4, 2024.

 Stat Pearls. Physiology of Takotsubo Syndrome. Updated March 6, 2023. Accessed February 4, 2024.

 Stat Pearls. Takotsubo Cardiomyopathy Updated May 22, 2023. Accessed, 31 January, 2024.