Heart Health | 08/24/2009 10:20 am
How Deadly Is a Broken Heart? by Dr. Holly Andersen

Editor’s Note: Dr. Holly Andersen is dual board certified in Internal Medicine and Cardiology, is a Fellow of the American College of Cardiology and the American College of Sports Medicine and is an assistant professor of medicine at the Weill Cornell Medical Center. Dr. Andersen has been selected as one of America’s "Best Doctors" every year by Castle Connolly since 2001, and in 2008 was named by the Consumers’ Research Council of America as one of "America’s Top Cardiologists." A recent story by wOw’s Sheila Nevins, "Heart-Break," prompted such response from our community that we had to wonder: What if broken hearts really can harm us physically? We reached out to Dr. Andersen for an answer.
Can you really die of a broken heart? The answer is yes. A traumatic breakup, an extreme argument or experiencing the death of a loved one can elicit the release of stress hormones that can trigger a heart attack in people prone to them, induce a life-threatening arrhythmia or cause a syndrome that mimics a heart attack in otherwise healthy hearts. This last syndrome, known as "Tako-Tsubo Syndrome," is rare and was first described in Japan, but is increasingly being recognized by clinicians in this country.
Tako-tsubo is a Japanese octopus trap — an egg-shaped jug that allows an octopus to crawl in, but not back out. We have seen hearts, under such aforementioned extreme emotional duress, take on this shape — the walls balloon out and are unable to squeeze properly. This syndrome occurs primarily in post-menopausal women who at the time also experience severe chest pain, have electrocardiograms that mimic huge heart attacks and release cardiac enzymes into the blood just like heart-attack victims. When taken to the cardiac catheterization lab, however, their hearts, now shaped like a tako-tsubo jug and barely pumping, are found to have normal coronary arteries — no blockages.
Very scary stuff indeed — but the good news is that more than 95 percent of the time, these patients, almost exclusively women, recover completely in several weeks to months without a detectable trace of the incident.























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Seven years ago today, just 45 minutes past midnight, my father passed away. His death certificate said "lung cancer," which had only been diagnosed two days before. I believe to this day he died from a broken heart. His health had been good until after my mother passed away 5 years before. They’d been married 47 years, went everywhere together, and never had a cross word to say to each other. They never raised their voices. (The closest they ever argued was when they went to the peach orchard and Mom would accuse him of picking bruised peaches. It remains one of my fonder memories because it was so funny.) If I hadn’t moved back in to take care of him, he probably would have died within 6 months. I worked part-time so I could take care of him, take him to the doctor and to physical therapy for his arthritic knees. About the only times he really enjoyed anything was when I took him to his annual army reunions (338th Engineers, WWII). The irony about his death was that it came 45 minutes after my mother’s birthday. (She would have been 85 yesterday.) I miss them both but I rejoice in the wonderful life they had together.
Our emotions, already tangled usually in the years or months before, peak with heartbreak. While the shock of sudden death often does not show itself immediately - at least full blown — longer term with the realization that the person is "alone" and often with no close support system, I have often seen them crumbling.
But more often, I have grown more used to seeing the long-term results of terminal sickness striking a marriage. Often, one partner is/was completely well in the beginning, still wanting to live life. Making the most of it. But it was not to be. The care of the partner begins to suck up, consume the other person who is not prepared to be a nurse providing 24-hour care.
As months go by, years often, I see my wonderful friend looking older, feeling not well, and in three cases so far, dying before the terminally ill person from what looks like constant caregiving and no rainbow in sight. Heart problems, heart arrythmmias crop up, and then — My point is that heartbreak can often happen before the death or break-up as all of us in our right minds can see this coming. We feel inadequate. We see an empty future. The closer a couple has been, the sooner the death of the one left behind in the later years. Or so it seems.
Is there an answer? Life happens … and it is extremely hard to watch.
Joan, you are so right. I have seen it with others and lived it personally myself. A chronically ill spouse not only affects the marriage but the whole family. I am a registered nurse and I knew about this for a long time but living with my husband’s heart desease for 20+ years did not prepare me for his anger, his resentment and for the deteriation of my own health. Even with the support of others (there were a few we could each lean on) it was not enough to sustain us mentally or emotionally.
The heartbreak occurs during the illness and and seldom can it be repaired. Answers??? Forgiveness for both parties (For us forgiveness was one sided). Forgiving yourself mainly for hurt feelings and resentment . Forgiveness heals. People could not see our pain because we hid it so well. My husband died in 1993 and I still carry the scars but I am Choosing to live life to the fullest. Joan S.
Joan S — welcome to another Joan on site - great! Again, you and I know well the frustration and anger exhibited by someone who is not going to get well. I believe that we - as people - are so much better if we can talk about it, get it out, so we can move on to the next day. The build-up of anger, even a person who was not angry before, is almost always directed at the person closest to him or her. Who else is there who is right in front of them? After a bit, you know that this is the case. It is directed to you, but it is not about you. However, knowing that or not, we are hurt. We feel like we have been stabbed - and for no reason. We are killing ourselves to be the smiling caregiver, always there. And what do we get in return? Pent-up anger. We are worn down over time. We would leave if we could. But we can’t - and we have to take what is said.
If we understand this - and boy! at the time, it is harder all the while to understand and take — later we can forgive. Forgetting? Do we forget hurts that go to our core? Unlikely. The damage is done. I think most of us carry those scars forever … but after a time, we realize that we still have been given a life ahead of us. Do we intend to feel sorry for ourselves forever? Some do. We see them. But the wiser of us know that there can be a rainbow around the corner that we would never dream of if we only get out our door and begin to live life again. I believe that we must make every day that we are well and active count. Be alive! I know personally that that way of thinking works — and works wonderfully. Life again can be a joy and overbalance those memories. I truly believe it - and hope you do, too. I think you do. Joan
I’m not surprised that the Dr. has indicated you can indeed die from a broken heart. As Joan (so eloquently as usual) pointed out, our emotions are tied directly to our physical being.
Once hurt by love, so many of us run from it. We avoid relationships like the plague offering up one excuse after another. When in the final analysis we avoid love because we don’t want to feel the hurt of a broken heart again. We remember that pain and it is a pain that stays with you.
The WoW website promotes it, just as countless other women’s websites do… the need to take care of ourselves emotionally and physically. However, how many of us truly heed those warnings and adopt the recommendations?
Hard to believe one can die of a broken heart, because surely I would have, when my beloved sister - brave, funny, strong - went undaunted to surgery for heart bypass, and came out blind. She lived three years after the surgery. Still brave, but, of course, never the same. How could she have been?…never again to see the blue sky, or raindrops, or the faces of your children.
Hearts
My heart hurts still, when I think of her. Every day.
One thing that really bugs me is when someone leaves a marriage after the partner gets sick. Do they go into the marriage and will only stay if the spouse is healthy? That is when their spouse needs them the most. I am not married and it makes me sick when I read about such stories.
One example is John McCain and his first wife who was in a car accident after she waited for him while he was a POW. He went on to marry the woman he had the affair with and probably only stays with her since she has the money.
Not surprising to me. Last year I tragically lost someone in a very (eeriely) similar fashion to a teenaged traumatic loss. Never could have foreseen going through it yet again. Doubt I was in danger of a heart attack; my grief had me fearing a nervous breakdown. Thank God that didn’t happen.