Can you really die of a broken heart?

One day after the death of her daughter Carrie Fisher in December 2016, Debbie Reynolds, the beloved star of “Singin’ in the Rain,” suffered a medical emergency and died.

Then just hours after her son’s funeral in late October 2017, Sheryl Stiles, the mother of a Las Vegas police officer killed during the mass shooting at the Route 91 Harvest Festival, suffered a heart attack and two days later died.

Her family said they believe she died from a broken heart.

Tragedy upon tragedy.

But can you really die of a broken heart?

According to Dr. Toni Miles and Dr. William H. Frishman, you certainly can.

“Losing a loved one is a terrible loss, and emotional heartache can cause physical problems, too,” said Frishman, a cardiologist, professor and chairman of the department of medicine at New York Medical College, and author of “Triumph Over Tragedy.”

According to Frishman, emotional stress can raise the level of the body’s stress hormones, blood pressure and heart rate, which can lead to death.

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While most of us can tolerate these stresses, they can occasionally overwhelm the heart and cause damage both in those with underlying heart disease and even in a healthy person or cause heart damage in individuals with underlying heart disease.

“We are all exposed to stress throughout our lives and tolerate it, but there are extreme cases where heart damage occurs,” Frishman said.

He said Reynolds’ death is the best example of broken heart syndrome.

“It also has been shown that when one partner dies in a long marriage, the survivor has a risk of dying that same year,” he said.

Miles, a professor of epidemiology in University of Georgia’s College of Public Health, has spent nearly a decade studying this phenomenon.

Although end-of-life issues related to the dying are the focus of most research, little is known about death’s impact on surviving friends and family — the young and the old.

Miles launched the “Mortality Project” in 2009 and recently concluded an eight-year-long study of the health effects of grief on surviving family and friends. The research was funded by the Centers for Medicare and Medicaid Services.

Each day 10,000 boomers turn 65. Based on this trend, the numbers of people experiencing grief and loss increase because not only do boomers tend to have many siblings, they also have many friends.

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“Each one could potentially see five people die in a very short span of time,” she said. “Public health research needs to understand the negative effect those deaths will have on survivors. If everyone who is grieving turned purple tomorrow, there would be almost 10 million purple people each year.”

In her most recent study, Miles spent about 60 hours at nursing homes and assisted living facilities listening to their stories about loss, how it happened, and the impact of that loss on their health.

“The thing that caught all of us by surprise was that the staff was affected as much by the loss as the family and that you didn’t have to be a direct care worker to feel the impact,” she said. “Cafeteria workers, bus drivers, people who sweep the floors and keep the place clean were all adversely impacted.”

Miles said there were basically two approaches to helping those left behind. One approach seeks to limit emotional upset. Administrators though it best to roll the dead out the back door. The other approach employs an established ritual in which people were allowed to say their goodbyes. In most cases, a ritual led to less staff turnover and lower family stress.

“I think the vast majority of people benefit from some kind of recognition that the person is gone,” Miles said. “You can’t tell people exactly what they need to do, but you’ve got to give them permission to grieve.”

What was also surprising, Miles said, was the amount of anger people had around the death.

One woman, for instance, confided she was angry at her husband for dying because she didn’t think he fought hard enough.

“The emotions can be all over the map,” she said. “It’s not just sadness. It’s depression, relief and guilt. You will not know how hard a thing will hit you until it actually happens. You can’t macho your way through this. This is when you really need other people.”

Based on her findings, Miles developed two guides for bereavement care — one for family and one for health care providers.

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Her top three tips?

Understand that grief begins before the person actually dies. “Anticipatory grief is the term professionals use. One example is dementia,” Miles said. “A person may live for many years yet their personality, their brains are gone early in the course of the disease.”

You don’t always need a licensed therapist to help you process your grief. Someone who has gone through the same thing can be as helpful or more so. Someone with the same experience can know when to talk and when to just sit quietly.

There are two phrases that a grieving person does not want to hear. “I know how you feel. You need to get over it.” We can never really know how they feel. However, we can express our sympathy for the passing.

“I think the vast majority of people benefit from some kind of recognition that the person is gone,” Miles said. “Loss can make you ill if you don’t have a mechanism to deal with the energy it creates in you. You (the person offering sympathy) can’t tell people exactly what they need to do, but you’ve got to tell them something.”