I have had many patients with the known risk factors for heart disease: obesity, smoking, and high blood pressure.
But I always suspected that there was another "hidden" risk factor that we weren't acknowledging, the impact of heartbreak on the heart. Now we have a name for that condition, called "broken-heart syndrome," and it's a very real heart risk factor.
Broken-heart syndrome was first discovered in Japan more than 25 years ago, and it's now becoming a recognized diagnosis. One of the biggest landmark studies, authored by Dr. Harmony Reynolds published, and published in the American Journal of Cardiology in 2012 identified 6,230 reported cases of broken heart syndrome in the U.S. Ninety percent of these cases were identified in women, most of whom were post-menopausal and averaged 65 years of age. But men can get broken-heart syndrome, too.
After years of trying to make the connection between heartbreak and heart disease myself, and authoring an entire book on the subject, I’d like to applaud Dr. Reynolds for spearheading research into why this condition happens most frequently in post-menopausal women. Broken-heart syndrome is far too under diagnosed, but the pain is real and it can be fatal.
What Causes Broken-Heart Syndrome?
In order to understand the underlying causes of broken-heart syndrome, Dr. Reynolds recruited 10 women for who experienced an attack of broken-heart syndrome and subjected them—as well as 10 control subjects who did not have broken-heart syndrome—to both physiological and psychological stressors to explore their response.
When one woman set off vital sign alarms while retelling her story, the investigators asked all 10 women to recall what was happening in their lives at the time their hearts attacked them.
The cases were intriguing. One women suffering an attack experiencing the intense excitement and joy watching her son play football. Another woman was caught off guard while traveling to a funeral, coupled with the stress of being in the throes of planning her child's wedding. There was also an English teacher who was exerting herself physically while cycling up a hill, but who also was care taking a sick parent and mindful that she needed to change her life.
While each of their stories were different, there was a powerful and consistent factor at play— as each woman recalled their broken-heart syndrome experience, they experienced a powerful change in their heart rate and blood pressure.
As I speculated so many years ago when observing the effect of emotional heartbreak on the physical heart, the researchers suspected that the central nervous system plays a strong role in broken-heart syndrome and some women are more vulnerable than others. For those who are vulnerable, when the sympathetic arm of the autonomic nervous system fires us up (as in the fight-or-flight response) their parasympathetic nervous system is less able to counteract that response—resulting in a broken-heart syndrome attack.
The only slight criticism I have of Dr. Reynolds study, with which she concurs, is that there were hypertensive women in the study group but none in the control group. That may have skewed the results, slightly. Nonetheless, I applaud and agree with her groundbreaking work.
What Can You Do to Protect Yourself?
What makes broken-heart syndrome so difficult to diagnose is that the symptoms can closely resemble a heart attack, including chest pain and difficulties breathing. In fact, on an EKG it can look exactly like a heart attack.
But unlike a heart attack where arteries are blocked, with broken-heart syndrome the arteries can be open. Plus, the damage to the heart can be much worse than it is after a heart attack. But the good news is that unlike a heart attack, the heart often recuperates and returns to normal if it's properly diagnosed and treated.
If you have heart attack symptoms during a time of intense joy, or stress, make sure you seek immediate medical attention. Interventions like yoga and meditation may also be able to prevent an attack of broken-heart syndrome if you're diligent about doing them during times of stress.
Plus, once we are able to identify those who are most vulnerable to broken-heart syndrome, we may be able to take stronger proactive measures to protect the heart—before broken-heart syndrome strikes.