The Case of the Broken Heart

A middle-aged woman woke up in the middle of the night with pain in her chest and shortness of breath. She was afraid that she was having a heart attack. So she called 911 and was taken to the nearest hospital where the cardiologist promptly performed a procedure called cardiac catheterization “to examine blood flow to the heart and to test how well the heart is pumping” (American Heart Association, 2009).

In the recovery room, the doctor told her and her husband that her “heart is fine and that there are no blockages.” “However, your heart muscle is weak. And for that reason, we are keeping you overnight to do further testing.” A couple of hours later, an echocardiogram (ultrasound of the heart) was performed which showed that her ejection fraction/EF (a measurement of how strong or weak the heart muscle is) is abnormally low. Her blood work however, showed that she did not have a heart attack. The doctor then proceeded to inform her that she has a classic case of the “broken heart syndrome” brought about by the sudden and violent death of her son. The next day, she was discharged with a follow up appointment in 7-14 days for a repeat echocardiogram. The doctor also told her that he expects to see full recovery then.

Broken heart syndrome is clinically known as “stress cardiomyopathy.” This can be triggered by extremely stressful event such as the unexpected death of a loved one. The body responds to the stressor by releasing large amounts of adrenalin and other stress hormones for days. These hormones and their breakdown products become chemically toxic to the heart and “stun” the heart muscle producing symptoms that mimic that of a heart attack – chest pain, shortness of breath, congestive heart failure and low blood pressure.

The Eye of Eliza
Creative Commons License photo credit: César S..

However, researchers have determined that stress cardiomyopathy is clinically different from that of a heart attack. For one, it occurs very suddenly and mostly in middle-aged women who were previously healthy and have no or few risk factors for heart disease. A certain blood work called cardiac enzymes that are elevated in cases of a heart attack come back normal. And the cardiac catheterization or angiogram usually shows no blockages in the arteries that are supplying the heart muscle.

Because of the “stunning” of the heart muscle, the echocardiogram can reveal a decreased EF. This condition can be life-threatening when the person goes into congestive heart failure and may even develop lethal abnormal heart rhythms. But in most cases, the condition improves quickly. And since it only”stuns” the heart muscle and “does not kill” it in the case of a heart attack, the heart muscle damage is only temporary. The heart muscle recovers completely and pretty quickly usually within a couple of weeks or so.

While not entirely understanding the mechanism of this phenomenon, our great-great grandparents believed that extreme emotions can physiologically affect the heart. Hence, the most common phrase “died with a broken heart.” But recent studies have shown that although broken heart syndrome occurs suddenly and unexpectedly and can be quite frightening, prognosis is excellent. Recurrence is rare. Recovery is quick and complete which leads us to the wonderful conclusion that “a broken heart can indeed be mended.”

Sources:

What is Cardiac Catheterization. American Heart Association. 2009 http://www.americanheart.org

Broken Heart Syndrome: Real But Potentially Deadly. John Hopkins Medicine. February,2005. http://www.hopkinsmedicine.org/press_releases/2005/02_10_05.html

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  • Mai

    Thank you Gwen for sharing with us this story and information about heart broken syndrome. I have been a nurse for 4 yrs now and I’ve never encountered such case.I dont even know there’s syndrome like that.Nice to know.
    Thanks again.

    God bless.

    • You’re welcome – glad to be of help to a fellow nurse.

  • mel f. encallado

    thanks Gwen for posting this. this is very much informative for we lots of cases like this in our place. i just heard about it just now. keep it up. and i’ll be anticipating more of your articles.

  • Thanks – glad to be of help.
    I hope to write more although I hardly find the time. I do have another article on this site – It’s A Color-Coded World. Hope you will find the time to read that too.

  • Dina

    Oooh, literal “broken heart”. Sounds sad, but the concept is amusing, in a way.
    would love to hear about the magic of making up 🙂

  • Hello ,
    Speaking of which, Does that make me so incredibly hot?
    Thanks

  • katkat G

    this is really nice and I’ve learned a lot first time I’ve red about it, thank you very much for sharing hope to read more of your articles :3

  • Mai

    Hi Gwen,

    The first time I read this article of yours, I was honestly hoping i could meet a patient with such case…and finally last month, i was assigned in cath lab…as i was looking at patient’s heart in the monitor while the doctor was doing xray, it was a bit strange…i could not see clearly the arteries…

    after the procedure, the doctor explained to us that the case of that patient is broken heart syndrome…i shared with him about your article and he kept on nodding , agreeing with me..but a week before that patient came in, i told the cath lab staff about that case u posted ..their first time to hear that case too…

    thanks again for sharing it in here…

    More power and God bless.

    • Hi Mai! Am glad the article helped. And what perfect timing that you got an actual case a week later.

  • this was just sad.. that she was literally heartbroken. Thanks for sharing.

  • Nice to know… interesting

  • tambaynarsforthemeantime

    I’ve heard of this since college but never known about what it’s like. thanks for sharing. Kudos 🙂

  • maria irene neri

    i have often heard this storylines, the patient suddenly died due to extreme emotional outburst leading to a heart attack but dont know how it happen.thank you for sharing enlightening facts about broken heart syndrome.it surely open our mindset about emotions as a triggering mechanism for a broken heart syndrome….
    pls. do share more informative stories too…..kudos to this article…

    • Thanks. I try to write more articles but I hardly find the time 🙁
      Emotions do affect our bodies physiologically but we never think about it because our bodies recover and/or compensate for the temporary change.