Just one day after actress Carrie Fisher died of a heart attack at age 60, her mother, Debbie Reynolds, 84, died of causes that were somewhat unclear, but involved complaints of shortness of breath. Friends and fans mourned them both on social media, with many sharing actor George Takei's view, shared in a tweet, that "Debbie died of a broken heart. She's with her daughter now."
It's long been accepted as a trope in movies and sad songs, but can someone really die from a broken heart?
According to research from Japanese physician Hikaru Sato, the answer is yes.
What is broken heart syndrome?
Sato's 1990 paper described life-threatening symptoms - including chest pain, shortness of breath, an elevated electrocardiogram and elevated cardiac enzyme levels - that looked much like heart attack, but which occurred in patients whose arteries were clear. Fatalities from such symptoms are rare, but possible.
The common thread among the women (and it was almost exclusively women) experiencing the syndrome was that all had undergone tremendous stress due to the loss of a loved one or other emotional events. Sato and his associates theorized that the left ventricle of the heart, with the main purpose of pumping blood, was weakened and mimicking the symptoms of a heart attack. He called the condition Takotsubo cardiomyopathy, but it quickly picked up a catchier name: "broken heart syndrome."
Researchers have since built on the conclusion that broken-heart syndrome is a real thing, from a study published in the New England Journal of Medicine in 2005 confirming that a flood of stress hormones may "stun" the heart into creating heart spasms in otherwise healthy people, to a 2011 piece in the journal Coronary Artery Disease suggesting a lack of estrogen may make post-menopausal women more vulnerable to cardiomyopathy.
More recently, a report published in the New England Journal of Medicine publicized the case of 62-year-old Joanie Simpson, whose heart, researchers said, "literally broke" after her beloved Yorkshire terrier died. While Simpson survived the ordeal, her diagnosis confirmed that the human-animal bond can also cause sufficient emotional stress to create cardiac consequences.
The most up-to-date research on Takotsubo cardiomyopathy comes from the longest follow-up study yet, presented at the American Heart Association Scientific Sessions in Anaheim, California, and funded by the British Heart Foundation. Researchers say broken-heart syndrome affects about 3,000 people each year in the UK with attacks that weaken part of the heart muscle, causing it to balloon and not pump properly.
At the same time, these researchers contradicted one long-held belief about broken heart syndrome. Whereas doctors used to rely on patients enjoying a quick and full recovery, even without treatment, this new study refutes that notion. With exercise testing and cardiac MRI scans, the team found that patients' heart function was often affected long after an event of broken heart syndrome and many of them had ongoing symptoms similar to heart attack sufferers.
Breakdown of a broken heart
The American Heart Association reinforces the existence of a "real-life" broken heart that can lead to cardiac consequences, noting that the syndrome can strike even if you're healthy. Women are more likely than men to experience the abrupt, severe chest pains that result from a surge of stress hormones.
While broken-heart syndrome is only rarely fatal, it's still important to understand the symptoms. AHA says to be alert to the following:
- Angina (chest pain)
- Shortness of breath, which you may experience even if you have no prior history of heart disease
- Arrhythmias (irregular heartbeats)
- Cardiogenic shock, which may occur during broken heart syndrome because the suddenly weakened heart can't pump enough blood to meet the body's needs.
Cardiogenic shock especially can be fatal for sufferers of broken-heart syndrome. It is also the most common fatal factor for people who die from heart attacks.
Cardiomyopathy can be distinguished from a heart attack in several ways, according to AHA:
- In broken-heart syndrome, symptoms occur suddenly after extreme emotional or physical stress.
- An EKG won't look the same for the two events.
- For broken-heart syndrome, blood tests won't indicate heart damage.
- Tests will show ballooning and unusual movement of the lower heart chamber, but they won't show blockage in the coronary arteries if it's broken-heart syndrome
- Most sufferers of broken-heart syndrome recover quickly, in a matter of days or weeks, compared to a month or more for a heart attack.
If your doctor suspects you're sufferng from broken-heart syndrome, you may require coronary angiography, which uses dye and special XX-rays to show the insides of your coronary arteries. Other diagnostics include blood tests, EKG, echocardiography and cardiac MRI.