David Baxter PhD
Late Founder
Broken heart syndrome
By Mayo Clinic Staff
Feb. 12, 2009
Broken heart syndrome is a temporary heart condition brought on by stressful situations, such as the death of a loved one. Many people who have broken heart syndrome may have sudden chest pain or may think they're having a heart attack. These broken heart syndrome symptoms may be brought on by the heart's reaction to a surge of stress hormones. In broken heart syndrome, a part of your heart temporarily enlarges, a condition called cardiomyopathy.
First described medically in 1991 by Japanese doctors, the condition was originally called takotsubo cardiomyopathy. Takotsubo is a type of pot used by Japanese fishermen to capture octopuses. When doctors take X-ray images of a person who's experiencing broken heart syndrome, part of his or her heart resembles the pot. Today, the condition is also referred to as stress cardiomyopathy, stress-induced cardiomyopathy or apical ballooning syndrome.
Broken heart syndrome is treatable, and usually requires about a week to recover.
Symptoms
Broken heart syndrome can mimic a heart attack, with common symptoms being chest pain or shortness of breath. Any long-lasting or persistent chest pain could be a sign of a heart attack, so it's important you take it seriously and call 911 if you experience chest pain.
When to see a doctor
If you're having any chest pain or shortness of breath after a stressful event, seek emergency medical assistance immediately.
Causes
It's thought that a brief surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn't clear.
Broken heart syndrome is often preceded by an intense physical or emotional event. Some of the triggers of broken heart syndrome have included news of an unexpected death of a loved one, a frightening medical diagnosis, domestic abuse or losing a lot of money. Physical stressors, such as an asthma attack, a car accident or major surgery, also have been known to trigger broken heart syndrome.
How is broken heart syndrome different from a heart attack?
Most heart attacks are caused by a complete blockage of a heart artery due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis). In broken heart syndrome, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.
Risk factors
Broken heart syndrome affects women far more often than men. Some research indicates nearly nine out of 10 cases occur in women, and of those, almost all are in women 50 or older.
Complications
In rare cases, broken heart syndrome is fatal. However, most who experience broken heart syndrome quickly recover and don't have long-lasting effects.
Other complications of broken heart syndrome include:
Preparing for your appointment
Broken heart syndrome is often diagnosed in an emergency setting, since many people with the condition think they're having a heart attack.
If you think you may have experienced an episode of broken heart syndrome, or are worried about your risk, make an appointment with your family doctor.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
If your doctor suspects you have broken heart syndrome, he or she will use these exams and tests to make a diagnosis:
There are no standard treatment guidelines for treating broken heart syndrome. At first, it's treated similar to a heart attack until the diagnosis is clear. There is no specific therapy, and most people stay in the hospital while they recover, which takes about a week.
Your doctor will likely prescribe blood pressure medications for you to take while you're in the hospital, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers or diuretics. These medications help reduce the workload on your heart while you recover. Usually, your doctor will tell you to stop taking these medications once you recover.
Procedures that are often used to treat a heart attack, such as coronary angioplasty and stent placement, are not helpful in treating broken heart syndrome. These procedures treat blocked arteries, which are not the cause of broken heart syndrome.
Prevention
There's a small chance that broken heart syndrome can happen again after a first episode. There's no proven therapy to prevent additional episodes; however, many doctors recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart.
By Mayo Clinic Staff
Feb. 12, 2009
Broken heart syndrome is a temporary heart condition brought on by stressful situations, such as the death of a loved one. Many people who have broken heart syndrome may have sudden chest pain or may think they're having a heart attack. These broken heart syndrome symptoms may be brought on by the heart's reaction to a surge of stress hormones. In broken heart syndrome, a part of your heart temporarily enlarges, a condition called cardiomyopathy.
First described medically in 1991 by Japanese doctors, the condition was originally called takotsubo cardiomyopathy. Takotsubo is a type of pot used by Japanese fishermen to capture octopuses. When doctors take X-ray images of a person who's experiencing broken heart syndrome, part of his or her heart resembles the pot. Today, the condition is also referred to as stress cardiomyopathy, stress-induced cardiomyopathy or apical ballooning syndrome.
Broken heart syndrome is treatable, and usually requires about a week to recover.
Symptoms
Broken heart syndrome can mimic a heart attack, with common symptoms being chest pain or shortness of breath. Any long-lasting or persistent chest pain could be a sign of a heart attack, so it's important you take it seriously and call 911 if you experience chest pain.
When to see a doctor
If you're having any chest pain or shortness of breath after a stressful event, seek emergency medical assistance immediately.
Causes
It's thought that a brief surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn't clear.
Broken heart syndrome is often preceded by an intense physical or emotional event. Some of the triggers of broken heart syndrome have included news of an unexpected death of a loved one, a frightening medical diagnosis, domestic abuse or losing a lot of money. Physical stressors, such as an asthma attack, a car accident or major surgery, also have been known to trigger broken heart syndrome.
How is broken heart syndrome different from a heart attack?
Most heart attacks are caused by a complete blockage of a heart artery due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis). In broken heart syndrome, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.
Risk factors
Broken heart syndrome affects women far more often than men. Some research indicates nearly nine out of 10 cases occur in women, and of those, almost all are in women 50 or older.
Complications
In rare cases, broken heart syndrome is fatal. However, most who experience broken heart syndrome quickly recover and don't have long-lasting effects.
Other complications of broken heart syndrome include:
- Disruptions in your heartbeat
- A fast or slow heartbeat
- Backup of fluid into your lungs (pulmonary edema)
Preparing for your appointment
Broken heart syndrome is often diagnosed in an emergency setting, since many people with the condition think they're having a heart attack.
If you think you may have experienced an episode of broken heart syndrome, or are worried about your risk, make an appointment with your family doctor.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
- Write down any symptoms you're experiencing, including any that may seem unrelated to broken heart syndrome.
- Write down key personal information, including a family history of heart disease, stroke, high blood pressure or diabetes, and any major stresses or recent life changes.
- Make a list of all medications, as well as any vitamins or supplements, that you're taking.
- Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Be prepared to discuss your diet and exercise habits. If you don't already follow a diet or exercise routine, be ready to talk to your doctor about any challenges you might face in getting started.
- Write down questions to ask your doctor.
- What is likely causing my symptoms or condition?
- What are other possible causes for my symptoms or condition?
- What should I do if these symptoms happen again?
- What kinds of tests will I need?
- What is the best course of action?
- What foods should I eat or avoid?
- What's an appropriate level of physical activity?
- What are the alternatives to the primary approach that you're suggesting?
- I have other health conditions. How can I best manage them together?
- Are there any restrictions that I need to follow?
- Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist? (You may need to ask your insurance provider directly for information about coverage.)
- Is there a generic alternative to the medicine you're prescribing me?
- Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous, or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Are you depressed or stressed?
- What kind of support do you have to cope with your stress?
If your doctor suspects you have broken heart syndrome, he or she will use these exams and tests to make a diagnosis:
- Personal history and physical exam. In addition to a standard physical exam, your doctor will want to know about your medical history, especially whether you've ever had heart disease symptoms. People who have broken heart syndrome typically don't have any heart disease symptoms before they're diagnosed with broken heart syndrome. Also, your doctor will want to know if you've experienced any major stresses recently, such as the death of a loved one.
- Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor detect irregularities in your heart's rhythm and structure.
- Chest X-ray. Your doctor will likely order a chest X-ray of your heart to see if your heart is enlarged or has the shape that's typical of broken heart syndrome.
- Echocardiogram. Your doctor may also order an echocardiogram to see if your heart is enlarged or has an abnormal shape, a symptom of broken heart syndrome. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function. Ultrasound waves are transmitted, and their echoes are recorded with a device called a transducer that's held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.
- Blood tests. Most people who have broken heart syndrome have an increased amount of certain enzymes in their blood. Your doctor may order blood tests to check for these enzymes to help diagnose broken heart syndrome.
There are no standard treatment guidelines for treating broken heart syndrome. At first, it's treated similar to a heart attack until the diagnosis is clear. There is no specific therapy, and most people stay in the hospital while they recover, which takes about a week.
Your doctor will likely prescribe blood pressure medications for you to take while you're in the hospital, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers or diuretics. These medications help reduce the workload on your heart while you recover. Usually, your doctor will tell you to stop taking these medications once you recover.
Procedures that are often used to treat a heart attack, such as coronary angioplasty and stent placement, are not helpful in treating broken heart syndrome. These procedures treat blocked arteries, which are not the cause of broken heart syndrome.
Prevention
There's a small chance that broken heart syndrome can happen again after a first episode. There's no proven therapy to prevent additional episodes; however, many doctors recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart.
