If it feels and acts like a heart attack, does that mean that it is one?

Not necessarily.

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 called “broken heart syndrome.”

Also referred to as a stress cardiomyopathy and the Japanese term Takotsubo, broken heart syndrome is not as deadly as a coronary, but it can mimic a heart attack in many ways. Both conditions share similar symptoms, including heart failure, irregular contractions and cardiac fluid buildup. In fact, the two are so similar that even medical professionals can have a difficult time distinguishing between them, until certain cardiac imaging and blood tests are performed.

However, there is one major difference between the two. Unlike a heart attack, people with broken heart syndrome typically don’t have visible signs of heart muscle damage or plaque buildup in their arteries.

How Emotions Affect Your Body and Heart

Broken heart syndrome got its name from its primary cause—extreme emotional stress.

Friedemann Schaub, MD, PhD, a cardiologist and molecular biologist says that major life-changing events, such as the death of a loved one, a divorce or even winning the lottery, can trigger stress hormones to flood a person’s body. This hormonal response can cause the 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 efficiently. “Your hormones are essentially asking your heart to do the impossible,” Dr. Schaub. “It’s the equivalent of running at full speed on a treadmill for eight hours straight.”

According to Dr. Schaub, long-term stress affects your health on three distinct levels:

  1. Behavioral: Unresolved stress can make you more prone to engaging in unhealthy and self-abusive behaviors, such as binging on food or alcohol and neglecting to get regular exercise.
  2. Physiological: An increase in the levels of stress hormones, such as cortisol and adrenaline, directly affects your cardiovascular system by elevating blood pressure and cholesterol levels and decreasing blood flow to the heart.
  3. 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.

Your emotions can have a profound impact on your physical health. This means that adopting proper stress management techniques is of utmost importance—particularly for people who are consistently exposed to stressful situations, like family caregivers.

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 Dr. Nieca Goldberg, 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 lead to cardiogenic shock, a condition where 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. Dr. Goldberg says it’s essential for anyone experiencing signs of a cardiac event of any kind to seek immediate medical treatment.

The good news is that broken heart syndrome is a rare condition that affects only about two percent of people with heart problems. Dr. Schaub says it is also reversible 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 permanent cardiac scarring, unlike 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 Dr. Goldberg hypothesizes that the answer may lie in how women handle stress. Individuals with a history of anxiety or depression are also at higher risk as well.

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Learning to Handle Stress

The best way to prevent broken heart syndrome and other damaging effects of stress is to devise healthier ways of coping with difficult emotions and troublesome situations. If you improve how you handle smaller daily stressors, you are more likely to cope better when something truly upsetting or surprising happens.

For caregivers, this means learning to recognize the signs of caregiver stress and making a plan for dealing with the day-to-day difficulties of caring for a loved one. The reality is that an elder’s care needs can change in an instant, but no one can prepare for every eventuality. What you can do, Dr. Schaub says, is take steps to have a more positive attitude and more effectively manage your stress:

  • Appreciate your efforts and the good things in life. “Most caregivers don’t acknowledge how much they’re actually doing,” says Dr. Schaub. “This makes it seem like they’re always swimming upstream. They can’t cure their loved one, and, in some cases, they can’t even make them comfortable. Because of this, they never allow themselves to feel a sense of accomplishment for what they have done for their elder.”
    He points out that positive emotions decrease the amount of stress hormones swirling around in your blood stream. They make you more likely to take care of yourself and put less physical stress on your body. Focusing on the positive aspects of life is difficult when things are so complicated, but it can have a significant impact on your health.
  • Care for your mind. Even if it’s only for 20 minutes, do something you enjoy every day. Read, take a bath, go for a walk or reach out to a friend. Having something to look forward to every day will keep your spirits up and can potentially give you an outlet for pent up emotions. If you are experiencing caregiver burnout, anxiety or depression, seek outside help from your doctor, a support group and respite care resources.
  • Care for your body. Do everything you can to safeguard your physical health. Nobody is perfect, but try to eat a healthy diet, get as much sleep and exercise as you can, and stay on top of your own doctor’s appointments.

Nurturing your emotional and physical health will reduce the likelihood that an overwhelming situation will set your heart over the edge.

Although it is something that most people prefer to avoid thinking about, it’s also important for caregivers to prepare for the inevitable passing of a loved one. Death of a beloved family member is one of the leading causes of broken heart syndrome.

The key, according Dr. Schaub, is not to give in to denial. While being realistic may not lessen your grief when they pass, it will help you mentally prepare and possibly lessen the shock or surprise you feel when the time comes. It will also enable you to find peace with your loved one before they go and feel more comfortable playing an active role in helping them pass on.

“Death is such an important part of life,” notes Dr. Schaub. “Too often we try to avoid it, which engenders a sense of powerlessness and elevates our stress.”