Can you really die from a broken heart?


When someone loses a loved one or endures a terrible loss, people might say they have a broken heart. But that’s a figure of speech, of course, typically meant to describe the mental pain associated with losing someone extremely close to you. But a proverbial broken heart can cause physical symptoms, too. And sometimes, in rare cases, those physiological changes—often accompanied by other underlying conditions—can be life-threatening.

A number of high-profile examples over the years have hinted at this: The most recent is Debbie Reynolds, who passed away last December just a few days after her daughter, fellow actress Carrie Fisher, died suddenly of a heart attack. According to The New England Journal of Medicine, researchers may have found another case in Texas: a study published this week describes a woman whose heart disease could be connected to the loss of her cherished pet.

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Debbie Reynolds and Carrie Fisher through the years
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Debbie Reynolds and Carrie Fisher through the years

Circa 1956, American actor and singer Debbie Reynolds smiles and holds her infant daughter, Carrie Fisher.

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A newcomer to the ranks of fatherhood, Eddie Fisher was named 'Father of the Year in TV' by the National Father's Day Committee. Mrs. Fisher (Debbie Reynolds) and the children presented Fisher with a handsome photo wallet containing their pictures. Carrie Frances is 19 months and son Todd (L) is 4 months old.

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Actress Debbie Reynolds, still deeply upset over separation from singer Eddie Fisher, was hospitalized here suffering exhaust indigestion. Meanwhile MGM Studios plan to shoot 'around' the actress until here where she is working in The Mating Game. Debbie holds her two children, Carrie and Todd, 8-mos, (right) in this photo made during the current shooting at the site.

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Debbie Reynolds with her daughter Carrie Fisher, 23 months old, smiles as she leaves the house September 9, 1958 to visit friends in Los Angeles, California. Husband Eddie Fisher and Miss Reynolds later revealed their separation.

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Carrie Fisher, 3, gives her mother Debbie Reynolds a hug after her afternoon nap in their home November 16, 1959 in West Los Angeles, California.

(Photo by Ray Graham/Los Angeles Times via Getty Images) .

Debbie Reynolds and Eddie Fisher with daughter Carrie Frances born October 21, 1956.

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12th February 1972

American actress Debbie Reynolds with her daughter Carrie Fisher.

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Carrie Fisher and Debbie Reynolds.

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Debbie Reynolds and Carrie Fisher during 11th Annual American Comedy Awards at The Shrine Auditorium in Los Angeles, California, United States.

(Photo by Ron Galella/WireImage)

Debbie Reynolds with her children Carrie and Todd Fisher, on the site of the new museum that will house her collection of film costumes.

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Actresses Debbie Reynolds (L) and Carrie Fisher (R) arrive at the premiere of 'Star Wars Episode III: Revenge of the Sith,' at the Loews Cineplex Uptown Theatre May 12, 2005 in Washington, DC. Star Wars premiers are taking place across the country tonight.

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Actress Carrie Fisher (L) and her mother, actress Debbie Reynolds, arrive for Dame Elizabeth Taylor's 75th birthday party at the Ritz-Carlton, Lake Las Vegas on February 27, 2007 in Henderson, Nevada.

(Photo by Ethan Miller/Getty Images)

Actress Debbie Reynolds (R) unveils the site of the new Hollywood Motion Picture Collection which will house her $30 million collection of movie costumes and props in Hollywood, June 19, 2001, with daughter Carrie Fisher at her side. The movie memorabilia museum, set to open February 2002, will be located at the Hollywood & Highland development which is also the site of the Kodak Theatre, permanent home of the Academy Awards ceremony. 

(Reuters Photographer / Reuters)

Actresses Debbie Reynolds and Carrie Fisher arrive at the premiere of HBO's documentary 'Wishful Drinking' at Linwood Dunn Theater at the Pickford Center for Motion Study on December 7, 2010 in Hollywood, California.

(Photo by Michael Caulfield/WireImage)

Carrie Fisher (L), Debbie Reynolds, and Billie Lourd attend Paley Center & TCM present Debbie Reynolds' Hollywood memorabilia exhibit reception at The Paley Center for Media on June 7, 2011 in Beverly Hills, California.

(Photo by Brian To/FilmMagic)

Actress Debbie Reynolds (L) and her daughter Carrie Fisher (R) arrive at the 2011 Primetime Creative Arts Emmy Awards in Los Angeles September 10, 2011.

(REUTERS/Danny Moloshok)

Actors Debbie Reynolds and Carrie Fisher arrive at the 2011 Primetime Creative Arts Emmy Awards held at the Nokia Theater L.A. Live.

(Photo by Frank Trapper/Corbis via Getty Images)

Actresses Debbie Reynolds, Carrie Fisher and Joely Fisher arrive at the premiere of HBO's documentary 'Wishful Drinking' at Linwood Dunn Theater at the Pickford Center for Motion Study on December 7, 2010 in Hollywood, California.

(Photo by Michael Caulfield/WireImage)

Carrie Fisher and Debbie Reynolds attend the all-star gala and press preview of Profiles in History's Debbie Reynolds-The Auction Finale at Debbie Reynolds's Dance Studio on May 14, 2014 in North Hollywood, California.

(Photo by Earl Gibson III/WireImage)

Actresses Debbie Reynolds (L), recipient of the Screen Actors Guild Life Achievement Award, and Carrie Fisher pose in the press room at the 21st Annual Screen Actors Guild Awards at The Shrine Auditorium on January 25, 2015 in Los Angeles, California.

(Photo by Ethan Miller/Getty Images)

Actress Carrie Fisher (L) and actress Debbie Reynolds attend TNT's 21st Annual Screen Actors Guild Awards at The Shrine Auditorium on January 25, 2015 in Los Angeles, California. 

(Photo by Charley Gallay/WireImage)

Actresses Debbie Reynolds (L), recipient of the Screen Actors Guild Life Achievement Award, and Carrie Fisher pose in the press room at the 21st Annual Screen Actors Guild Awards at The Shrine Auditorium on January 25, 2015 in Los Angeles, California.

(Photo by Ethan Miller/Getty Images)

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This phenomenon is still not completely understood. But potential cases come up often enough for the condition to earn a name: Takotsubo syndrome, or Takotsubo cardiomyopathy. Literally translated from Japanese as “octopus trap,” the name references the way in which the problem develops. In a classic heart attack, a clot forms (typically from plaque) within a person’s blood vessels. This restricts blood flow, with its life-sustaining oxygen, to the heart. But in the case of Takotsubo syndrome, what appears to be a massive heart attack comes without any identifiable clot to cause it.

Symptoms of Takotsubo mimic a normal heart attack. The patient often complains of shortness of breath, has dangerously high blood pressure, and experiences chest pain. But instead of a clot, weakened heart muscles are to blame. The many clinical case reports and studies on Takotsubo syndrome suggest that this condition almost always presents in individuals who have experienced some sort of intense trauma or extreme emotional hardship—losing a loved one, especially a spouse or a child.

An oft-cited 2005 study, also in the New England Journal of Medicine (which reviewed 19 cases of the condition, 18 of which were in women) as well as a few other smaller studies, suggest that the cause of the syndrome is likely rooted in a hormonal response to extreme stress. When someone undergoes a particularly traumatic event, the body often releases a flood of stress hormones into the bloodstream. The stress hormones themselves can cause muscles in the heart to become weak. If you looked at the heart, it would almost seem like it was being squeezed or held tightly at the bottom, forcing the top half to balloon out. The effect is similar to a trap often used to catch octopus, hence the condition’s name.

While Takotsubo syndrome can strike anyone at any age who is experiencing severe emotional distress or trauma, it’s rarely fatal. In most cases, the person recovers in a number of weeks and has few lingering effects. But in certain situations, it can be fatal. According to a report out last year in The New York Times, because Takotsubo syndrome primarily affects women—and is usually only fatal in older women—doctors think that estrogen might play a role in protecting the heart’s blood vessels. Since estrogen levels tend to decrease with age, older woman might be at a higher risk of the syndrome turning deadly.

The Texas woman, who was 61 years old when doctors treated her in 2016, was monitored in the hospital for two days before being sent home. Because the condition can, in rare cases, become fatal—and because the symptoms of a heart attack are often extremely similar—it's important to see a doctor promptly if you begin to experience any signs of Takotsubo syndrome. With more case reports like these, researchers are gaining a better understanding of what the condition is and who is most at risk. With this information, they say, they will be better able to treat it.

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