A broken heart may conjure up bittersweet stories and love songs – but experiencing a traumatic event may actually cause cardiac consequences. Broken heart syndrome, also known as Takotsubo cardiomyopathy, occurs when someone experiences sudden and acute physical or emotional stress, which can rapidly weaken the heart’s left ventricle. Here’s what you need to know about the causes, symptoms and treatment for broken heart syndrome. Understanding broken heart syndrome Broken heart syndrome, which was first described in Japan during the 1990s, is a condition in which the left ventricle – the heart’s primary pumping chamber – balloons out, while the base of the heart contracts. This may be dangerous, because it negatively affects the heart’s ability to pump blood. A heart attack happens when blood flow, which brings oxygen to the heart, is restricted or entirely cut off. Although heart attacks and Takotsubo cardiomyopathy are both forms of muscle heart failure and can cause similar symptoms, there are some key differences worth noting. ‘Broken heart syndrome’ is real, looks like a heart attack – and on the rise According to Dr Jay Woody, an emergency medicine doctor and chief medical officer of US-based health care provider Intuitive Health, heart attacks are often caused by blockage from a fatty build-up known as plaque in the wall of the arteries – which can lead to a clot that impedes blood flow to the heart muscle. Takotsubo cardiomyopathy, meanwhile, is triggered by a severe emotional or physical response that affects the heart muscle directly. Broken heart syndrome can set in even if you’re otherwise healthy, according to the American Heart Association, which is why it’s important to understand the causes and symptoms. What causes broken heart syndrome? According to Woody, the name “broken heart syndrome” refers to the fact that the condition can be brought on by emotionally traumatic events that negatively affect the physical heart . He says the most common example of a stressor is grief from losing a loved one, but notes that intense feelings of fear, anger, surprise and other emotions can also be a trigger. Tips for a healthy heart – are you taking care of yours? Some other events that might cause the condition include: A significant and distressing medical diagnosis (or other bad news) A car accident A tense or explosive argument Devastating financial loss Domestic violence Severe illness A 2020 study discovered an uptick in patients diagnosed with Takotsubo cardiomyopathy since the coronavirus outbreak – reaching 7.8 per cent compared to 1.7 per cent before the pandemic. Additionally, patients with this condition during the pandemic were found to have a longer hospital stay than those before the pandemic. Researchers noted that the pandemic has added multiple layers of stress to people’s lives – not only are many dealing with economic changes, emotional issues, loneliness, and isolation, but they’re also grappling with constant concerns about themselves or their loved ones becoming ill. This additional stress can have physical effects, as evidenced by the increasing diagnoses of Takotsubo cardiomyopathy. Broken heart syndrome can also be caused by physical stressors, including: Difficulty breathing (due to an asthma attack or emphysema) Low blood sugar A drop in blood pressure Stroke Seizure High fever Significant blood loss Severe injuries Even positive events, like walking into a surprise party or winning the lottery, can bring on Takotsubo cardiomyopathy. “Regardless of the cause of stress, the body’s response is similar: to secrete a large amount of the stress hormone adrenaline,” says Dr Jennifer Haythe , a critical care cardiologist at Columbia University Centre in New York. “In some instances, this can lead to Takotsubo cardiomyopathy, which can mimic a heart attack.” While Takotsubo cardiomyopathy is seen in men and younger women, a 2015 study found that a staggering 89.8 per cent of cases occurred in women between the ages of 58 and 75. The most common triggers were found to be physical (36 per cent), followed by emotional shock (27.7 per cent). Notably, a trigger could not be found in 28.5 per cent of patients. The study also revealed that patients with Takotsubo cardiomyopathy were almost twice as likely as those with acute coronary syndrome (such as heart attack) to have a psychiatric or neurological disorder. A study published in 2021 found that diagnoses of broken heart syndrome are increasing much more among women ages 50 to 74 than younger women or men of any age. Scientists say this illustrates that women middle-aged and older are at increased risk of developing the condition. Miracle of the human heart, and how to keep yours healthy Common signs and symptoms “ Patients who have broken heart syndrome may experience chest pain, shortness of breath, and low blood pressure very shortly after an extremely stressful event,” says Woody. According to Johns Hopkins Medicine and the American Heart Association, other symptoms and signs of Takotsubo cardiomyopathy include: Arrhythmia (irregular heartbeat) Cardiac shock (usually due to a heart attack, when the heart cannot pump enough blood and oxygen to the brain, kidneys and other vital organs) Diaphoresis (sweating) Dizziness These symptoms may set in anywhere from minutes to hours after a physically or emotionally stressful event. “Some people describe it as feeling like an elephant is sitting on their chest,” says Haythe. Sweating, jaw pain, left arm pain, nausea, vomiting, lightheadedness, palpitations, and stomach ache are all possible symptoms. If you feel any new symptoms in your chest, or have crushing chest pain or shortness of breath, experts urge you to seek medical attention immediately. Why heart attack survivors need regular physical activity “Heart attacks have similar symptoms as broken heart syndrome, so it’s important to get a diagnosis because heart attacks can be fatal,” says Woody. When a patient experiences symptoms similar to broken heart syndrome, medical professionals will typically rely on imaging studies, blood tests, and cardiac biomarkers to observe any potential abnormalities before making an official diagnosis. Can you die from a broken heart? A 2015 study revealed that the rate of death for patients with Takotsubo cardiomyopathy was 5.6 per cent per year. While death is rare, heart failure occurs in roughly 20 per cent of patients. While it can take up to two to three months to recover from a heart attack, Woody says a person will typically recover from broken heart syndrome within one to six weeks, and make a full recovery within one to two months. Treatment for broken heart syndrome will depend largely on which symptoms the patient is experiencing, and that, according to Woody, will dictate the severity of the condition. He says clinicians will often recommend medications like beta-blockers, ACE inhibitors, and diuretics. Meditation and exercise are also proven to be effective strategies for reducing stress, which may play a role in triggering the disorder. Some of the complications that can result from broken heart syndrome, according to Woody, include fluid in the lungs or irregular heartbeat. Obstruction of blood flow from the left ventricle and rupture of the ventricle wall are also possible, though rare. At 39, in the best shape of his life, he had a heart attack “Symptoms can be treated effectively by medical professionals and are usually not long-lasting,” he adds. “Broken heart syndrome can be dangerous, but the condition improves rapidly, which means patients with a naturally strong heart shouldn’t experience lasting effects.” Although broken heart syndrome is short-term and easily treatable, Woody says it’s still important to seek medical support to prevent it from causing lasting heart damage, which can lead to other symptoms. Haythe says that people who have experienced one episode of Takotsubo cardiomyopathy are at risk for a recurrence. However, with quick recognition, exclusion of other causes, and proper treatment, the condition has an “excellent prognosis”, with most patients making a complete recovery, she says. Like what you read? Follow SCMP Lifestyle on Facebook , Twitter and Instagram . You can also sign up for our eNewsletter here .