Why the pain of a “broken heart” can be more than a metaphor

[3 min read]

In this article:

• Have you ever been told that you won't die of a broken heart? Maybe not, but it can cause a serious cardiac condition called Broken Heart Syndrome.  
• The condition is caused by a surge of intense emotion.It's difficult to distinguish from a heart attack, sometimes requiring a CT angiogram or cardiac catheterization to diagnose. 
• If you think you are experiencing Broken Heart Syndrome call 911, and if you think you may be having a heart attack go to your nearest emergency room.   

February is when we think of hearts and flowers. But for some people, an intense emotion—whether it’s grief, heartbreak or even overwhelming joy—can trigger a very real heart condition known as Broken Heart Syndrome.

According to Providence Swedish Edmonds cardiologist Neil Siecke, M.D., the condition, called Takotsubo cardiomyopathy, is far more than a metaphor.

“The body maintains a reserve supply of adrenaline that can be released during times of stress,” Dr. Siecke explains. “With Broken Heart Syndrome, there’s a sudden surge, essentially a massive release of stress hormones all at once. The heart muscle becomes overwhelmed, and it’s damaged. It has to recover for a few days.”

That surge of stress hormones essentially stuns the heart, weakening its ability to pump effectively. Unlike a heart attack, there is no blocked artery, but the symptoms can look almost identical.

“It’s very difficult to distinguish from a heart attack even by a cardiologist,” Dr. Siecke says. “Patients often experience chest pain or pressure, shortness of breath, EKG changes typical of a heart attack and elevated troponin levels, the blood test used to diagnose heart attacks. To confirm the diagnosis and rule out a true heart attack, physicians often need to perform a cardiac catheterization or CT angiogram to make sure that the arteries are not blocked.

Broken Heart Syndrome disproportionately affects women, particularly post-menopausal women, though the reason remains unclear. “No one knows why it affects women more frequently. It’s an area of active research,” he says.

While recovery is typically fast, the condition can be serious. “We can often see the heart recover in 48 to 72 hours, with full recovery in a few weeks,” Dr. Siecke says. Still, he cautions that complications can occur. “People can die from Broken Heart Syndrome, but we have very good treatments in the hospital.”

It can also happen more than once. “We often recommend medications like carvedilol, which are beta blockers. They help the heart recover right after an event and, in the long run, help block surges of adrenaline from reaching the heart,” he says.

There are no clear warning signs. And even experienced physicians cannot always tell the difference between a heart attack, panic attack or stress-related chest pain. “I’ve been doing this for more than 20 years, and I’m still wrong sometimes,” Dr. Siecke says. “The symptoms overlap, so it’s best to get evaluated quickly.”

Learn more and find a physician or advanced practice clinician (APC)

The team of specialists at the Providence Swedish Heart & Vascular Institute has access to the latest treatments and technology and the expertise to know how to use it safely and effectively. Call 206-320-4100 to learn more about the vascular care we offer.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care physician. You can also connect virtually with your doctor to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual, you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.

Information for patients and visitors 

Additional resources

A life saved at the gym: How quick action, CPR and AED made the difference

A doctor's persistence and a daughter's love saved this Seattle dad's life

Hypertension is a silent and deadly threat

The Providence Swedish Heart & Vascular Institute is transforming cardiovascular care

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

The Providence app offers world-class health care with human connection

Follow us on Facebook, Instagram and X. 

His advice is simple: If symptoms are severe, call 911. If you think you might be having a heart attack, go to the emergency room. For milder stress-related symptoms, remove yourself from the situation, take cleansing breaths or go for a walk to help break the cycle.

“There’s a reason we’ve culturally referred to a ‘broken heart’ for so many years,” Dr. Siecke says. “It’s common to feel mild chest pressure or tightness during emotional distress, and in many cases, it’s nothing more serious than an emotionally broken heart.”