heart attack
Brittany Hambleton
Brittany Hambleton
January 22, 2024 ·  4 min read

Stress Can Cause a Cardiac Event that Resembles a Heart Attack

At one point or another, everyone experiences the physical pain of loss. Whether it’s the passing of a loved one, the end of a relationship, or even simply the stress of having a fight with a friend, emotional anguish can often be felt throughout your entire body.

And while dying of a broken heart seems like something out of a Shakespeare drama, the possibility does actually exist. Sudden stress can cause a cardiac event that feels like a heart attack, and can sometimes have significant health consequences.

Broken Heart Syndrome

Known in the medical community as takotsubo cardiomyopathy, “broken heart syndrome” is one of the most significant ways stress can affect your heart [1]. 

Takotsubo cardiomyopathy occurs when severe emotional or physical stress causes a weakening of your heart’s left ventricle, which is its main pumping chamber [2]. The symptoms are very similar to that of an actual heart attack, including chest pain and shortness of breath, but the mechanism behind it is different. They come on very suddenly, usually triggered by a stressful event.

“Its presentation isn’t subtle,” says Lauren Gilstrap, MD, a cardiologist at Dartmouth Hitchcock Medical Center. “People think they’re having a heart attack.” [1]

An actual heart attack, however, is different. A heart attack is caused by blocked arteries, which renders the heart incapable of pumping enough blood throughout the body, also referred to as acute heart failure [3].

“Takotsubo cardiomyopathy is a fundamentally different phenomenon than a heart attack,” Gilstrap says. “The arteries are completely fine and the blood supply is completely normal, but all of a sudden, the heart doesn’t squeeze.” [1]

The symptoms of Broken Heart Syndrome could include:

  • Chest pain and shortness of breath after severe stress (emotional or physical)
  • Electrocardiogram abnormalities that mimic those of a heart attack
  • No evidence of coronary artery obstruction
  • Movement abnormalities in the left ventricle
  • Ballooning of the left ventricle [2]

What Causes Takotsubo Cardiomyopathy?

Medical professionals are still uncertain what exactly causes the condition, but they believe it may be associated with a sudden hormonal surge from the body’s fight or flight response. Whatever the cause, the outcome is the same: the heart is not functioning properly, and there is not enough blood being pumped throughout the body [1].

Potential triggers could include:

  • A sudden drop in blood pressure
  • Serious illness, surgery, or medical procedure (e.g., cardiac stress test)
  • Severe pain
  • Domestic violence
  • Asthma attack
  • Receiving bad news (such as a diagnosis of cancer)
  • Car or other accident
  • Unexpected loss, illness, or injury of a close relative, friend, or pet
  • Fierce argument
  • Financial loss
  • Intense fear
  • Public speaking
  • A surprise party or other sudden surprise [2]

Acute Stress Isn’t the Only Problem

At one time it was thought that takotsubo cardiomyopathy only occurred in people who experienced acute or sudden stress, however, it is becoming increasingly evident that chronic stress, such as a large project at work or trouble with a loved one, can also trigger an episode [1].

This is because chronic stress can increase your risk for hypertension, which is a major risk factor for heart disease. Occupational stress, a stressful social environment, and low socioeconomic status can all contribute to chronic stress, which can have an adverse effect on your heart [5].

Although the condition happens very suddenly, the effects can last much longer. After experiencing takotsubo cardiomyopathy, your heart may not pump efficiently for several weeks, and you could take up to two months to recover completely [2].

Who is the Most At-Risk?

Takotsubo cardiomyopathy is still not incredibly common- 98 percent of people who experience the symptoms of a heart attack and are admitted to the hospital are, in fact, having a true heart attack. This means that only two percent of them have broken heart syndrome [6].

The most common demographic to experience takotsubo cardiomyopathy are women between the ages of 58 and 75. This group makes up more than 90 percent of cases, and about five percent of women who think they’re having a heart attack are actually experiencing this phenomenon [2].

One possible explanation for this is that women may experience higher levels of emotional stress than men [7].

How to Manage Stress to Protect Your Heart

Doctors and medical researchers are discovering more and more how important stress management is for your overall health. Not only can both acute and chronic stress affect your heart, but many other parts of your body as well.

“When stress is excessive, it can contribute to everything from high blood pressure, to asthma to ulcers to irritable bowel syndrome ,” said Ernesto L. Schiffrin, M.D., Ph.D., physician-in-chief at Sir Mortimer B. Davis-Jewish General Hospital, and professor and vice chair of research for the Department of Medicine at McGill University in Montreal [8].

According to Schiffrin, the best ways to decrease stress is to exercise, maintain a positive attitude, avoid excessive caffeine, and eat a healthy diet [8].

Other ways to deal with stress include:

  • Learn and practice relaxation techniques; try meditation, yoga, or tai-chi for stress management.
  • Learn to manage your time more effectively.
  • Set limits appropriately and learn to say no to requests that would create excessive stress in your life.
  • Make time for hobbies, interests, and relaxation.
  • Get enough rest and sleep. Your body needs time to recover from stressful events.
  • Don’t rely on alcohol, drugs, or compulsive behaviors to reduce stress.
  • Seek out social support. Spend enough time with those you enjoy [9].

If you suffer from anxiety, Schiffrin suggests that you speak with your doctor to develop a treatment or management plan that works for you [8].

Keep Reading: 10 Warning Signs Of A Heart Problem