Expert answers: Can you really die from a broken heart?

There’s no denying that we can feel immense grief and sadness following the breakdown of a relationship, when a loved one passes away or even when we lose a pet, but can you really die from a broken heart?

It’s a question many people have asked after Northamptonshire Police in the United Kingdom recently claimed that a 93-year-old woman died of a broken heart after three men pretending to be police officers ransacked her home and left her with post-traumatic stress disorder.

Another recent story claimed that a woman who fatally struck a young girl with her car by accident experienced so much heartache over the incident that she died, while another woman began noticing symptoms similar to a heart attack after she lost her family pet and endured financial hardship and stress.

Professor Thomas Marwick, CEO and head of imaging research at the Baker Heart and Diabetes Institute, tells Starts at 60 that broken heart syndrome is in fact a real condition, but can also be known as stress cardiomyopathy or takotsubo cardiomyopathy.

“The condition is thought to relate to imbalance of the autonomic nervous system, which regulates bodily functions such as heart rate and respiratory rate,” he explains, pointing out that the syndrome is often provoked by adrenaline in a stressful situation. “It’s usually a negative effect, but it can be a positive one.”

This means that while the death of a loved one, a heated argument, receiving life-changing news or being in a frightening situation can cause a person to experience broken heart syndrome, it’s also possible for positive surprises, such as receiving good news, to result in similar symptoms.

The good news though is that death is actually very uncommon for people who experience a ‘broken heart’ and when death does occur, it’s usually a result of heart rhythm problems or heart failure, where the heart isn’t able to pump enough blood around the body.

It’s also no coincidence that most of the recently reported cases of broken heart syndrome occur in women, with Marwick explaining that almost all people who experience episodes are female. He says: “It seems to be much more of a problem in women than in men, more commonly women who are post-menopausal.”

It’s also women in their 70s and 80s who are most at risk, but researchers don’t fully know why this is the case yet. According to Marwick, the most plausible explanation is that postmenopausal women have lower levels of oestrogen in their system and the hormone may have a protective effect against broken heart syndrome.

“There’s some experimental evidence from animal models to support that, but exactly the mechanism of how that protects against adrenaline, that’s still being worked out,” he explains. “Although it seems to be linked to oestrogen, there’s no evidence that therapeutic or prophylactic oestrogen is a wise thing to do. In fact, there’s very good evidence that continuing oestrogen therapy after menopause is detrimental.”

It’s also unknown how people can protect themselves from broken heart syndrome, given they’re usually only diagnosed after they experience an episode. In these cases, people are typically treated with a class of drugs called beta blockers to protect the heart against the effects of adrenaline.

From his personal experience treating patients with broken heart syndrome, Marwick says it’s usually people who are less fit and less active who are more at risk, but there are warning signs that people can look out for that could point to an episode. He explains: “The symptoms are very much like a heart attack. They’re essentially identical.”

This could include anything from chest pain, tightness and shortness of breath to dizziness, nausea and heart burn. Anyone developing any of these symptoms needs to treat them seriously, call an ambulance as soon as possible or get to hospital for treatment.

Here, doctors will perform a coronary angiogram and will be able to diagnose broken heart syndrome if the coronary angiogram shows no significant signs of coronary disease. Symptoms typically dissipate within a week of the initial episode and the heart is usually fully recovered within a few months. The biggest issue is that many people will experience more than one episode.

“Recurrence is the thing that’s the concern. About 10 or 15 per cent of people developing this can have a recurrence,” Marwick says. “It will be very unwise for somebody developing chest pain in a stressful context just deciding for themselves that they had stress-related cardiomyopathy because it could equally be a heart attack.”

If you or someone you love experiences aching in the chest during stressful situations, talk to your GP or health professional about ways you may be able to better reduce stress and potentially reduce the risk of suffering broken heart syndrome.