Countless novels and films depict a character, heartbroken from the loss of a loved one or due to a break-up, suddenly clutch their chest and collapse. Although this may seem like a dramatic plot device, it is actually possible to die from stress.
The condition, colloquially termed broken heart syndrome for obvious reasons, is known as takotsubo cardiomyopathy or stress-induced cardiomyopathy. As the name suggests, the heart suddenly goes into congestive heart failure after sudden emotional stress. In simpler words, the heart’s ability to pump blood is sharply reduced due to muscle weakness and blood is not circulated properly. This causes blood to dam up and cause symptoms such as chest pain, breathlessness, fluid overload and much more.
The characteristics of this disease is that the heart temporarily enlarges so that the tip (apex) bulges out while the function of the base (upper part of the heart) is normal. The muscles in the apex is thinned while the base has hypertrophied and thickened. This gives the appearance of a thin pocket with a thick entrance, thus giving the name takotsubo cardiomyopathy, which means “octopus trap” in Japanese.
Given the patient survives the initial heart failure, their condition improves over the course of two months. The patient may also need psychiatric help or antidepressants and sedatives to ease the stress that led to the heart failure.
As the presentation is very similar to a normal myocardial infarction (“heart attack”), the diagnosis may be difficult. The cause has not been identified yet, but researchers believe it to be due to a combination of blood vessel spasms disrupting blood supply to the heart and high levels of catecholamines. As catecholamines (adrenaline/noradrenaline) are released in great quantities in times of stress, this theory has some plausibility. A similar thing happens when patients with heart problems are exposed to significant levels of fear – their heart goes into overdrive and develop cardiac arrest due to an exacerbation of their condition.
The concept of dying from intense emotions such as anger and stress is found in almost every culture, where a person collapses and falls deathly ill after shocking news or a particularly stressful experience. But modern medicine has only just begun to understand the scientific reasoning behind this strange phenomenon.
It has also been noted that takotsubo cardiomyopathy tends to affect post-menopausal women, especially widows. Interestingly, most of these patients are not considered “at risk” for a heart attack and generally healthy.
Thus, stress alone can be enough to “break” someone’s heart and cause sudden death.