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 condition called “broken heart syndrome.”

Also referred to as stress cardiomyopathy and the Japanese term takotsubo cardiomyopathy, 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 sometimes have a difficult time distinguishing between them until 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, M.D., Ph.D., cardiologist, molecular biologist and author of “The Fear and Anxiety Solution: A Breakthrough Process for Healing and Empowerment with Your Subconscious Mind,” says that major life events, such as the death of a loved one, 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,” Schaub explains. “It’s the equivalent of running at full speed on a treadmill for eight hours straight.”

According to Schaub, long-term stress affects the body on three distinct levels:

  1. Behavioral: Unresolved stress can make you more prone to engaging in unhealthy 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.

Can You Die of a Broken Heart?

It may be a well-worn cliché, but Nieca Goldberg, M.D., board-certified cardiologist, medical director of Atria New York City and founder of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center, confirms it is possible to die of a broken heart. If left untreated, broken heart syndrome can cause dangerous arrhythmias (irregular heartbeats) 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. 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 relatively rare. Studies suggest this condition affects between one and three percent of people with heart problems. Schaub assures 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 is that broken heart syndrome disproportionately affects older women, accounting for 85–90 percent of all cases. It’s unclear why females are more affected by stress cardiomyopathy, but Goldberg hypothesizes that the answer may lie in how women handle physical and emotional stress differently than men. Individuals with a history of mental health conditions like anxiety or depression are also at higher risk.

How to Prevent Broken Heart Syndrome

The best way to prevent broken heart syndrome and other stress-related health issues is to find more effective methods of handling difficult emotions and situations. If you improve how you manage smaller daily stressors, you are more likely to cope better when something truly upsetting or shocking happens.

Since research shows that most family caregivers are women over age 50 and this role comes with a great deal of pressure, physical and mental self-care are very important. This means learning to minimize and cope with caregiver stress, making use of respite resources, prioritizing your own needs, and seeking ample caregiver support.

The reality is that an elder’s care needs—and life as a whole—can change in an instant. No one can prepare for every eventuality. However, listening to your body and developing a care plan for your loved one that also meets your needs will help you shrug off day-to-day stress and endure more serious events.

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Schaub encourages practicing mindfulness and embracing more positive thinking to benefit both mind and body.Most caregivers don’t acknowledge how much they’re actually doing,” he points out. “They feel like they’re always swimming upstream.”

Changing your outlook can decrease the amount of stress hormones circulating in your blood and make you more likely to take care of yourself. Focusing on the positive aspects of life is difficult when things are so complicated, but it can have a significant impact on your well-being.

Lastly, although it is something that most people prefer to avoid thinking about, caregivers should prepare for the inevitable passing of their care recipients. Death of a beloved family member is one of the leading causes of broken heart syndrome.

The key, according Schaub, is not to give in to denial. While being realistic may not lessen your grief when they die, 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 Schaub. “Too often we try to avoid it, which engenders a sense of powerlessness and only elevates our stress.”

Adopting a realistic and positive mindset and nurturing your emotional and physical health while caregiving will reduce the likelihood that an overwhelming situation will set your heart over the edge.