Can You Truly Die of a Broken Heart?

In the annals of history, there have been instances where the world collectively mourned the loss of great artists. One such poignant moment occurred in 2016 when the world bid farewell to two legendary performers - Carrie Fisher and Debbie Reynolds.

Carrie Fisher, beloved for her iconic role as Princess Leia in the Star Wars franchise, passed away at the age of 60, sending shockwaves of grief across the globe. In a heartbreaking twist of fate, just one day later, her mother, legendary actress and singer Debbie Reynolds, also passed away at the age of 84. The proximity of their deaths led many to speculate that the loss of her daughter played a pivotal role in Debbie Reynolds' passing. While the notion of succumbing to a "broken heart" might sound poetic, it is not as rare or bizarre as it may seem. This phenomenon is medically referred to as Takotsubo Cardiomyopathy, a condition first discovered in Japan. Takotsubo Cardiomyopathy, often known as "broken heart syndrome," closely mimics the symptoms of a heart attack. However, unlike a typical heart attack, it is not caused by major artery blockages. Instead, this condition manifests due to extreme stress or emotional shock, leading to the heart taking on a pot-like shape, similar to the vessels Japanese fishermen use to catch octopuses, known as "Takotsubo." This structural change narrows the flow of blood, a result of the combined impact of stress hormones and a stunned heart muscle.

In the case of Debbie Reynolds, we can only theorize that the emotional stress following her daughter's death may have contributed to her own tragic passing. As Dr. Sunil Shah from St. George's, University of London, explains, "We often use the term 'broken heart' to signify the pain of losing a loved one, and our study shows that bereavement can have a direct effect on the health of the heart." The British Heart Foundation corroborates this by stating, "About three-quarters of people diagnosed with takotsubo cardiomyopathy have experienced significant emotional or physical stress before becoming unwell." Recognizing the Signs and Symptoms While both a heart attack and Takotsubo Cardiomyopathy manifest as cardiac distress, they are fundamentally distinct conditions.

The most common symptom of a "broken heart" is shortness of breath and chest pains, akin to angina, which can be easily confused with a heart attack. Additionally, arrhythmia, characterized by irregular heartbeats, is often present in cases of broken heart syndrome. Unlike a heart attack, which typically results from accumulated clots and blockages, Takotsubo Cardiomyopathy manifests suddenly and severely due to extreme emotional or physical stress. Moreover, it does not inflict any physical damage, and patients usually recover within a day or a few days, without any long-term adverse effects. In contrast, heart attack survivors require at least a month for complete recovery. Although death is relatively rare in cases of broken heart syndrome, it can be fatal when individuals are grappling with severe depression or anxiety. The elderly face a higher risk of death due to weakened heart muscles associated with aging. The exact cause of this cardiomyopathy remains unknown. However, the theory of stress playing a critical role holds substantial weight, as even physically, mentally, and emotionally fit individuals experience negative physiological responses when exposed to stress and hormone surges. According to Dr. Matthew Lorber, a psychiatrist at New York's Lenox Hill Hospital, "Broken heart syndrome –which is, in fact a real thing - is when someone finds out some shocking news, typically terrible news, and there's a massive release of these stress hormones that are released into the bloodstream, and the heart is then bombarded with these stress hormones." Lorber further elucidates that shocking news can encompass various scenarios, from receiving divorce papers to being fired from a job. He emphasizes that even good news delivered suddenly can induce stress and release stress hormones. As he aptly puts it, "Anything that causes a shock or startles can cause broken heart syndrome." Patients and Risk Factors While broken heart syndrome, or Takotsubo Cardiomyopathy, can affect anyone, studies reveal that it predominantly afflicts women. Individuals with neurological issues, such as seizures, are also prone to this condition. As previously noted, it poses a more significant risk to the elderly due to age-related muscle weakening. In cases where a weakened heart cannot adapt to the stress-induced changes, the situation can escalate to fluid accumulation in the lungs, changes in blood pressure, or even heart attacks, all of which could lead to fatality. Dr. Paul Wright, Chairman of Neurology at North Shore University Hospital in New York, highlights that the cardiac arrhythmias associated with broken heart syndrome may also lead to strokes. He underscores, "We know that stress can induce cardiac arrhythmias – irregular rhythms in the heart – that can cause clots to be formed and thus produce large strokes." While the loss of a loved one or the end of a relationship can be emotionally painful, it is uncommon for someone to die of a broken heart. Nevertheless, these rare occurrences contribute to the intrigue of this medical phenomenon, infusing it with a sense of poetic mystery. In the case of Debbie Reynolds following the death of her daughter, it appears that a "broken heart" syndrome offered an explanation for her passing. Whether science can entirely fathom the depths of human emotion and its impact on our physical well-being remains an ongoing quest. While rare and enigmatic, Takotsubo Cardiomyopathy serves as a poignant reminder of the intricate interplay between the human heart and the profound emotions that shape our existence.