If it feels like a heart attack and acts like a heart attack, does that mean that it is a heart attack?
Chest pain and tightness, arm pain and shortness of breath are all hallmark heart attack symptoms, but they are also signs of another, lesser-known heart condition—Takotsubo (or "broken heart") syndrome.
Heart attack's less-dangerous doppelganger
While not as deadly as a full-blown coronary, broken heart syndrome—also referred to as a stress cardiomyopathy—can mimic a heart attack in many ways.
Both share similar symptoms, including heart failure, irregular contractions and cardiac fluid buildup.
In fact, the two conditions are so similar that even medical professionals can have a difficult time distinguishing between them, until certain cardiac imaging and blood tests are performed.
There is one major difference between the two cardiac conditions. Unlike a heart attack, people with broken heart syndrome typically don't have visible signs of heart muscle damage, or plaque build-up in their arteries.
Triggered by emotions
Broken heart syndrome got its name from its primary cause—extreme emotional stress.
Friedemann Schaub, M.D., a cardiologist and molecular biology specialist says that major, life-changing events (such as the death of a loved one, a divorce, even winning the lottery) can trigger stress hormones to flood a person's body, causing their heart to go into a dangerous state of overdrive.
If exposed to elevated levels of stress hormones for too long, the heart becomes enlarged with blood and can no longer pump blood efficiently. "You're hormones are essentially asking your heart to do the impossible. It's the equivalent of running all-out on a treadmill for eight hours straight," Schaub says.
Can you die of a broken heart?
It may be a well-worn cliché, but it is possible to "die of a broken heart," according to Nieca Goldberg, M.D., Medical Director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center,
If left untreated, broken heart syndrome can cause dangerous arrhythmias and even cardiogenic shock (when the heart becomes too weak to circulate enough blood throughout the body). According to the American Heart Association, cardiogenic shock is the symptom that typically kills people who suffer major heart attacks.
That's why Goldberg says it's essential for anyone experiencing signs of a cardiac event to seek immediate medical treatment.
The good news is that broken heart syndrome is a rare condition, affecting only about two percent of people with heart problems.
It is also reversible, says Schaub. If prompt medical treatment is sought, someone suffering an episode of stress cardiomyopathy can recover in as little as a week, typically without sustaining any kind of cardiac scarring—which makes it vastly different from a heart attack.
The bad news (at least for women) is that most people who experience episodes of stress cardiomyopathy are women age 50 and older. The precise reason why females are more affected by broken heart syndrome is unknown, but Goldberg hypothesizes that the answer may lie in how women process stress.
How your emotions can affect your heart
Your emotions can have a profound impact on your physical health and wellbeing.
Research indicates that people who successfully adopt a positive, yet realistic attitude are 20 percent less likely than those who have a negative, or even lukewarm approach towards life.
This means that adopting proper stress management techniques is of utmost importance—particularly for people who are consistently exposed to stressful situations (i.e. family caregivers).
Schaub, who is also the author of, "The Fear and Anxiety Solution," says that stress affects your health on three, distinct levels:
- Behavioral: Unresolved stress can make you more prone to engaging in unhealthy behaviors, self-abusive behaviors, such as binging and over-indulging on food or alcohol, and neglecting to get regular exercise.
- Physiological: An increase in the levels of stress hormones, such as cortisol and adrenaline, directly affects you cardiovascular system by elevating blood pressure and cholesterol levels and decreasing blood flow to the heart.
- Cellular: Stress hormones also impact your long-term health by latching onto different cells in your body, weakening them and making them more susceptible to damage.
He points out that positive emotions, which decrease the amount of stress hormones swirling around in your blood stream, can have the opposite effect—making you more likely to take care of yourself, and putting less physical stress on your body.
Preparing for the coming storm of stress
The best way to prevent broken heart syndrome is to figure out a way to stave off the stress surges that cause it.
Learn to recognize the signs of caregiver stress and make a plan for dealing with the day-to-day difficulties of caring for a loved one.
But an elder's care needs can change in an instant—how can you prepare for the emotional onslaught that accompanies each unforeseeable shift?
The truth is that you can't prepare for every eventuality. What you can do, says Schaub, is take steps to more effectively manage your stress:
- Appreciate your efforts and what you do have.
- Celebrate the good things. "Most caregivers don't acknowledge how much they're actually doing," says Schaub. "This makes it seem like they're always swimming upstream. They can't cure their loved one—many times they can't even make them comfortable. They never allow themselves to feel a sense of accomplishment for what they have done for their elder." Remember, you leave a legacy through caregiving that can be powerful and inspiring, if you let it.
- Care for yourself. Even if it's only for 20 minutes, do something you enjoy doing every day.
It's also important to prepare for the inevitable passing of a loved one. Death of a beloved family member is a major cause of broken heart syndrome.
The key, according Schaub, is to avoid denial while the person is still living. This will enable you to feel comfortable playing a more active role in helping your loved one pass on. Find peace with them before they go and visualize yourself having a productive reaction to their death. See yourself handling the stress and sadness appropriately and honoring them in the way that you feel is best.
"Death is such an important part of life," says Schaub. "Too often we try to avoid it, which engenders a sense of powerlessness and elevates our stress."