What Is Broken Heart Syndrome? Symptoms, Causes, Diagnosis, Treatment, and Prevention

• The sudden death of a loved one
• Natural disaster
• An accident or major physical trauma
• The dissolution of a relationship
• Domestic violence
• Receiving a serious, acute medical diagnosis, such as cancer or a terminal illness
• Severe financial loss
• An intense argument
• Extreme fear
• Exhausting physical exertion
• Use of illicit drugs, such as cocaine or excessive stimulants

There are several known risk factors for broken heart syndrome including:

• Female sex The majority of people who experience broken heart syndrome are female.
• Older age Broken heart syndrome is more commonly seen in adults over the age of 50.
• Mental health conditions Individuals living with anxiety or depression have a higher risk of broken heart syndrome.

If you present to a doctor or emergency department with signs of broken heart syndrome, it’s important to rule out a heart attack. Your provider will complete a physical exam and review your medical history before ordering several tests, which may include:

• Electrocardiogram (EKG), which measures the heart’s electrical activity and shows how fast or slow the heart beats. An EKG can show if you’re having a heart attack, but can also signal broken heart syndrome.
• Coronary angiogram, which checks for blockages in the arteries, which would signal a heart attack. If no blockages are present and a heart attack has been ruled out, your doctor will look for signs of broken heart syndrome.
• Blood work to test for elevated levels of specific enzymes that signal broken heart syndrome
• Echocardiogram, which utilizes sound waves to display images of your heart. Doctors can check if the heart is enlarged or irregular in shape, which can be signs of broken heart syndrome.
• Heart MRI, which uses magnetic resonance imaging to create detailed pictures of the heart

Prognosis of Broken Heart Syndrome

The majority of people make a full recovery from broken heart syndrome, according to the American Heart Association (AHA). Because the heart muscle doesn’t suffer any permanent damage, the likelihood of a long-term heart issues is low. It’s also unlikely to recur.

In rare instances, broken heart syndrome can be fatal. About 1 percent of all cases lead to death, per Cleveland Clinic.

Most people make a full recovery from broken heart syndrome within four to six weeks after the first symptoms appear, Mayo Clinic reports.

But some people do experience complications, including low energy levels for months after their diagnosis.

There’s no cure for broken heart syndrome and no set standard of treatment. Doctors typically treat the condition as they would a heart attack and patients usually stay in the hospital until they feel better.

Medications to treat broken heart syndrome include:

• ACE (angiotensin-converting enzyme) inhibitors, which prevent a specific enzyme in the body from narrowing blood vessels, thereby allowing better blood flow
• ARBs (angiotensin receptor blockers), which block the action of specific hormones on the heart and blood vessels to prevent damage
• Aspirin, to improve circulation and prevent blood clots
• Beta-blockers, which slow down the heart rate
• Water pills, or diuretics, to remove water from the body and decrease fluid buildup

No interventions have been proven to prevent broken heart syndrome. But since sudden distress is a known risk factor, it may be helpful to learn ways to manage stressful situations. This can include relaxation techniques like meditation, yoga, and deep breathing; connecting with others who are going through similar traumatic or stressful events through support groups; and seeking professional help through a counselor or therapist.

Healthy lifestyle habits can also keep your heart strong. These include:

• Exercise. The Centers for Disease Control and Prevention (CDC) recommends at least 150 minutes of physical activity per week.
• Eat a heart-healthy diet. For a healthy heart, the AHA advises sticking to a Mediterranean diet, which focuses on fruits, vegetables, whole grains, nuts, seeds, and lean proteins.
• Don’t smoke tobacco.
• Prioritize sleep. Adults should aim to get seven to nine hours of sleep per night, the CDC advises.
• Keep up with doctor’s appointments. Stay up-to-date on medical appointments and screenings.

The majority of people with broken heart syndrome recover completely and don’t have any lasting effects. Complications are rare, but when they do occur, they may include:

• Low blood pressure
• Arrhythmias, or irregular heart beats
• Blood clots
• Pulmonary edema, a condition that occurs when fluid backs up into the lungs
• Heart failure

In very rare instances, broken heart syndrome can cause death.

The true prevalence of broken heart syndrome is unknown, but research studies estimate the incidence is 1 to 2 percent of all patients suspected of heart attack.

According to a study published in October 2021 in the Journal of the American Heart Association, 88 percent of all cases of broken heart syndrome occur in females. The risk of broken heart syndrome is highest among adults older than 50, per the same study.

Research examining racial differences in prevalence and outcomes of broken heart syndrome is limited. One study suggests Black Americans experience a higher incidence of complications from the condition.

The research, published in June 2020 in the journal ESC Heart Failure, examined health data on more than 97,000 Americans with a diagnosis of broken heart syndrome from 2006 to 2014. The researchers compared the impacts of the condition on white Americans and Black Americans. The analysis showed that Black Americans were more likely to experience complications, including cardiac arrest, invasive mechanical ventilation, kidney injuries, and longer hospital stays than white Americans. The study authors concluded that it’s not that broken heart syndrome has a greater impact on Black Americans, but that these racial disparities could be attributed to other factors, including socioeconomic factors, such as income and health insurance status, as well as coexisting health conditions.

Since stress is a major trigger of broken heart syndrome, conditions associated with stress, including depression and anxiety, come with a higher risk. Symptoms of broken heart syndrome are very similar to a heart attack. Here’s what you should know about both.

Depression and Anxiety Disorders

Researchers are still working to better understand the causes and risk factors for broken heart syndrome, but it’s clear acute emotional or physical stress plays a role. Since stress is strongly associated with psychiatric disorders like depression and anxiety, those living with these mental illnesses have a higher likelihood of broken heart syndrome, according to a research review published in September 2020 in Cureus. Per the review, treatment of these disorders with therapies like cognitive behavioral therapy and selective serotonin reuptake inhibitors (SSRIs) could reduce the risk of broken heart syndrome.

Heart Attack

The symptoms of broken heart syndrome mimic those of a heart attack, which occurs when blood flow to the heart is partially or completely blocked. A heart attack is a very serious heart event and treatment is needed right away to prevent complications and death. Therefore, it’s important to know the signs of a heart attack so you know when to seek help. These include:

• Chest pain, which may feel like squeezing, pressure, or tightness
• Pain that spreads to the shoulder, back, neck, or arms
• Shortness of breath
• Dizziness or feeling faint
• Cold sweat
• Nausea
• Fatigue

If you or a loved one experiences these symptoms, call for emergency medical help right away.