Broken Heart Syndrome: Why You May Be at Risk

We’ve all heard the saying that someone “died of a broken heart” after losing a loved one. This expression is generally used figuratively — meaning, to describe the crushing loss one feels from heartbreak. Dying of a broken heart, however, is more than just a line used in a novel or movie — it’s an actual medical syndrome, and some people really CAN die of a broken heart. But who is at risk? And does having diabetes play a role?

What is broken heart syndrome?

Broken heart syndrome, or stress cardiomyopathy, is definitely for real, although it’s relatively uncommon. First described in Japan in 1990[1], this condition mimics symptoms of a heart attack, and it can occur when a person experiences sudden physical or emotional stress. When this happens, damage to the left ventricle (the bottom left portion of the heart) occurs, causing it to balloon outwards. The shape of the ventricle looks like a takotsubo pot, a Japanese vessel used to trap octopuses (hence its other name, takotsubo cardiomyopathy).

Because the ventricle is weakened, the heart can no longer pump blood as well as it should. This condition can be fatal, but fortunately, broken heart syndrome is treatable and most people make a full recovery.

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What are the symptoms of broken heart syndrome?

Broken heart syndrome can closely mimic symptoms of a heart attack. Symptoms may include:

Because chest pain and shortness of breath are primary symptoms, a person with this condition may initially be misdiagnosed as having a heart attack. If you or a loved one is have any of these symptoms, seek emergency medical care right away.

What causes broken heart syndrome?

Stress, both emotional and physical, is often the cause of this condition, although up to 30% of people have no identifiable trigger[3] at the time of their initial symptoms, according to the website Johns Hopkins Medicine.

Examples of emotional triggers include:

Examples of physical stressors include:

Although rare, some medications can trigger broken heart syndrome by causing a surge of hormones:

While the exact cause of broken heart syndrome isn’t known, health experts believe that stress hormones, such as adrenaline “stun” the heart[9], causing changes in heart muscle cells or heart blood vessels that prevent the ventricle from contracting effectively, according to Harvard Health Publishing. In addition, adrenaline may bind to heart cells, causing large amounts of calcium to enter and preventing the cells from beating properly.

What are some complications of broken heart syndrome?

The Cleveland Clinic states that complications are rare[10], but may include:

People who have diabetes may have a higher risk of death from broken heart syndrome compared with people who don’t have diabetes. In addition, a case report published in the Current Research in Diabetes & Obesity Journal described a case of a person with diabetes who developed multiple recurrences[11] of this condition that was triggered by diabetic ketoacidosis (DKA)[12]. After improved diabetes control, the person recovered well and had no further episodes of broken heart syndrome.

Who is at risk for broken heart syndrome?

While anyone can experience this condition, certain groups of people have a higher risk:

How is broken heart syndrome diagnosed?

A physical exam and various tests are used to diagnose broken heart syndrome (and rule out a heart attack). These may include:

Indicators of broken heart syndrome are:

How is broken heart syndrome treated?

There isn’t a standard treatment for this condition; initially, treatment might be the same as treatment for a heart attack until a diagnosis is confirmed. People usually need to stay in the hospital while they recover. It may take a month or longer to fully recover, too.

Medications are generally prescribed to help the heart recover and also reduce the strain on the heart. These may include:

A health care provider may recommend cardiac rehabilitation, as well as techniques to help manage stress. The underlying cause of broken heart syndrome, especially any physical triggers, may warrant changes to the treatment plan. Luckily, this condition is treatable and there is a low risk of it happening again.

Can broken heart syndrome be prevented?

While health experts believe that certain physical and emotional factors can trigger broken heart syndrome, it’s not clear why this occurs in some people and not others. It’s also not known why some people get this condition without any clear triggers. In the meantime, steps that you can take to help lessen the chance of this happening to you include:

Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,”[15] “Does Diabetes Hurt Your Heart?”[16] “Fight Off Heart Disease With These Five Heart-Healthy Foods”[17] and “Seven Signs of an Unhealthy Heart.”[18]

Endnotes:
  1. described in Japan in 1990: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893309/
  2. sign up for our free newsletters: https://dsm.diabetesselfmanagement.com/newsletter/
  3. 30% of people have no identifiable trigger: https://www.hopkinsmedicine.org/health/conditions-and-diseases/broken-heart-syndrome#:~:text=Two%20kinds%20of%20stress%20%E2%80%94%20emotional,time%20of%20their%20initial%20symptoms.
  4. Asthma attack: https://dsm.diabetesselfmanagement.com/education/diabetes-and-asthma-is-there-a-link/
  5. Low blood sugar: https://dsm.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/what-is-hypoglycemia-symptoms-treatments/
  6. COVID-19: https://dsm.diabetesselfmanagement.com/covid-19/
  7. depression: https://dsm.diabetesselfmanagement.com/blog/dealing-diabetes-depression/
  8. thyroid issues: https://dsm.diabetesselfmanagement.com/healthy-living/diabetes-and-thyroid-conditions/
  9. “stun” the heart: https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome
  10. complications are rare: https://my.clevelandclinic.org/health/diseases/17857-broken-heart-syndrome
  11. diabetes who developed multiple recurrences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364728/
  12. diabetic ketoacidosis (DKA): https://dsm.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/dka-what-to-know-and-how-to-deal/
  13. diagnosed with broken heart syndrome: https://www.heart.org/en/news/2021/10/13/broken-heart-syndrome-is-on-the-rise-especially-among-older-women
  14. lessen or manage stress: https://dsm.diabetesselfmanagement.com/healthy-living/emotional-effects/seven-easy-ways-to-de-stress-and-feel-better-fast/
  15. “Be Heart Smart: Know Your Numbers,”: https://dsm.diabetesselfmanagement.com/education/be-heart-smart-know-your-numbers/
  16. “Does Diabetes Hurt Your Heart?”: https://dsm.diabetesselfmanagement.com/education/does-diabetes-hurt-your-heart/
  17. “Fight Off Heart Disease With These Five Heart-Healthy Foods”: https://dsm.diabetesselfmanagement.com/blog/fight-off-heart-disease-five-heart-healthy-foods/
  18. “Seven Signs of an Unhealthy Heart.”: https://dsm.diabetesselfmanagement.com/education/seven-signs-of-an-unhealthy-heart/

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