Broken Heart Syndrome: Causes, Symptoms, Treatment & Recovery

A sudden weakness of the heart muscle causes broken heart syndrome. This normally happens when people go through an extremely stressful event, physical or emotional. This condition can last for a few days or even for weeks. It is normally a temporary condition.

What is Broken Heart Syndrome?

A person with broken heart syndrome may experience sudden chest pain and believe that they are having a heart attack. This is a syndrome where some of your heart muscles are weakened. This results in affecting the other parts of the heart working harder. It interrupts the way the heart pumps blood. When your heart doesn’t pump blood well, your whole body is affected. Your blood carries oxygen to every cell in your body. The heart contracts more forcefully during broken heart syndrome. The condition may also be triggered by a severe physical illness or surgical procedure. It can be treated with medicines.

Broken heart syndrome is also called:

• Stress cardiomyopathy
• Takotsubo cardiomyopathy
• Recurrent takotsubo cardiomyopathy
• Apical ballooning syndrome

Types

• Apical: Most of the cases belong to this type, making it one of the most common types. In this, the lower half of the heart is affected.
• Mid-ventricular: The middle part of the heart’s lower chambers (ventricles) is affected. The affected region appears as a ring or band encircling the heart. The areas of the heart that are above and below the ring function perfectly.
• Basal: This is similar to the mid-ventricular type, except that the ring or belt appears higher up. Only the portion of the heart beneath the band functions normally. It is rare to have this condition.
• Focal: This is an extremely rare type; only a small area of the heart is affected compared to the other types. The area that is affected sticks out like a bulge from the rest of the heart. Resultantly, the opposite side of your heart curves inward towards the bulge.

Symptoms

Symptoms of broken heart syndrome show up within minutes or hours after the stressful event. When stress hormones are released temporarily, it stuns your heart muscle, and the symptoms resemble those of a heart attack. You could have any of the following symptoms:

• Sudden or severe chest pain (angina)
• Shortness of breath
• The left ventricle of your heart is getting weakened
• Irregular heartbeats (arrhythmias)
• Low BP 
• Palpitations
• Fainting

Causes and Risk Factors

It is still unclear what causes broken heart syndrome. When you have a stressful event like a car accident, divorce, or job loss, a surge of stress hormones like adrenaline may damage the heart for a short time. It is not clear whether these hormones hurt the heart or if something else is the cause of it. Broken heart syndrome may have been caused by a temporary squeezing of the large or small arteries of the heart. People with this condition have a change in the structure of the heart muscle.

Any stressful event, like the following, can cause broken heart syndrome:

• Sudden good (winning a lottery) or bad news,
• Extreme anger,
• Grief from the death of a loved one
• Intense fear (a robbery),
• Health issues like an asthma attack or COVID-19.

Risk factors could be:

• Age: Older than 50 years of age
• Sex: More common in women than men
• Mental health conditions: People with anxiety and depression are at a higher risk
• If you had a neurological disorder like a seizure or stroke

Diagnosis and Treatment

The doctor will assess your medical history and conduct a thorough physical examination. Several tests may be ordered:

• A blood test to detect enzymes that could indicate damage to the heart muscle.
• An electrocardiogram ECG
• Coronary Angiography
• Echocardiography
• X-ray of the chest
• Heart MRI
• Ventriculogram (A dye is injected into your left heart ventricle, and an X-ray is then taken that shows the size and pumping efficiency of this heart chamber)

Imaging can show the damaged areas of the heat. However, to rule out a heart attack, coronary angiography may be needed.

While there’s no specific cure for broken heart syndrome, medications can aid recovery, and most patients fully recover with proper treatment.

Medication used to treat broken heart syndrome:

• Aspirin: It improves circulation and prevents blood clots
• ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers), which lower blood pressure and fight any inflammation
• Beta-blockers, which slow down your heart rate
• Diuretics to reduce any build-up of fluid

Complications

• Heart Failure
• Pulmonary edema
• A blood clot in the wall of your left ventricle
• Tearing or rupture of the left ventricle of the heart
• Interruption or blockage of the blood flow leaving the left ventricle
• Cardiogenic shock
• Heart Block

Recovery and Outlook

Most people recover from broken heart syndrome without any long-term heart problems. If a health problem like a stroke, asthma, or seizure triggered your broken heart syndrome event, then the doctor may advise on how to manage these conditions. Although people make a full recovery in a few days or weeks, some people may have low energy levels for months after the event. If this leads you to feel depressed, reach out to a healthcare provider.

Those who get broken heart syndrome from an emotional event recover better than those who get it from a medical issue like surgery or illness. This may be caused by critical illnesses.

Broken heart syndrome rarely causes death. It is a temporary condition with full recovery.

You may have to take prescribed medicines for three to six months after the event. See your healthcare provider at regular intervals or as advised. You may either have broken heart syndrome again or other health problems after several weeks or even years after the first event.

Understanding, Recovery, and Prevention

Broken heart syndrome cannot always be prevented. However, reducing stress and caring for your health may lower the risk.

• Practice stress management, such as yoga, meditation, and mindfulness
• Exercise regularly, eat healthy food, and get enough sleep
• Avoid tobacco, alcohol, and drugs
• Stay connected with friends, family, or support groups
• Have regular medical check-ups

Some people may need long-term medicines, such as beta blockers, to reduce the effects of stress on the heart.

People talk about a “broken heart” in a light-hearted way when talking about their emotional experiences. However, broken heart syndrome can happen after a stressful emotional or physical event. It is a temporary condition, and people make a full recovery after it. It has symptoms like those of a heart attack. Never try to self-diagnose this condition. It is always important to rush to a hospital and ensure that the relevant tests are done to diagnose the condition.

Frequently Asked Questions