Can a bad breakup cause heart problem?

If you’ve been through a sudden romantic breakup or the surprising loss of a loved one, you know what a broken heart feels like. But can these experiences actually—literally—break your heart?

Yes, they can, and they do.

The condition is called broken heart syndrome. Also known as stress cardiomyopathy, neurogenic stunned myocardium, takotsubo cardiomyopathy, and apical ballooning syndrome, it can occur at times of acute emotional stress, such as the sudden death of a loved one—hence the “broken heart” description.

Mimicking acute coronary syndrome, broken heart syndrome is accompanied by reversible left ventricular apical ballooning of no apparent cause with an absence of angiographically significant coronary artery stenosis. It can be easily misdiagnosed as a heart attack because patients typically present with classic myocardial chest pain and moderately increased cardiac enzymes (particularly troponins). It’s also characterized by electrocardiographic abnormalities, such as ST-segment elevation and/or T-wave inversion.

What is it?

Takotsubo cardiomyopathy is a weakening of the left ventricle, the heart's main pumping chamber, usually as the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, a serious accident, or a natural disaster such as an earthquake. (For additional examples, see "Stressors associated with takotsubo cardiomyopathy.") That's why the condition is also called stress-induced cardiomyopathy, or broken-heart syndrome. The main symptoms are chest pain and shortness of breath.

Features of takotsubo cardiomyopathy Chest pain and shortness of breath after severe stress (emotional or physical) Electrocardiogram abnormalities that mimic those of a heart attack No evidence of coronary artery obstruction Movement abnormalities in the left ventricle Ballooning of the left ventricle Recovery within a month.

The precise cause isn't known, but experts think that surging stress hormones (for example, adrenaline) essentially "stun" the heart, triggering changes in heart muscle cells or coronary blood vessels (or both) that prevent the left ventricle from contracting effectively. Broken-heart syndrome occurs more often in women than men, especially after menopause.

Takotsubo Cardiomyopathy Treatment

There is no standard treatment for broken-heart syndrome. It depends on the severity of symptoms, and whether the person has low blood pressure or evidence of fluid backing up into the lungs. Clinicians often recommend standard heart failure medications such as beta blockers, ACE inhibitors, and diuretics (water pills). They may give aspirin to patients who also have atherosclerosis (plaque buildup in the arterial walls).

Although there's little evidence on long-term therapy, beta blockers (or combined alpha and beta blockers) may be continued indefinitely to help prevent recurrence by reducing the effects of adrenaline and other stress hormones. It's also important to alleviate any physical or emotional stress that may have played a role in triggering the disorder.