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Understanding Stress Cardiomyopathy: 'Broken Heart' Syndrome

Medically reviewed by Mia Dacumos, MD · Nephrology · Makati Medical Center

Written by Lorraine Bunag, R.N. · Updated Jun 10, 2021

Understanding Stress Cardiomyopathy: 'Broken Heart' Syndrome

If someone tells you that you could die of a broken heart, you might want to believe them. That’s because science has proven that broken heart syndrome actually exists. But what is it? And how do you identify the symptoms of broken heart syndrome?

What is Takotsubo or Stress Cardiomyopathy?

Takotsubo cardiomyopathy got its interesting name from the Japanese word, “Tako-tsubo,” which is a fishing pot meant to trap octopus.

In Takotsubo cardiomyopathy, the left ventricle, which is the main pumping chamber of the heart, gets bigger (apical ballooning) and eventually assumes a pot’s shape. This change decreases the ability of the left ventricle to pump blood throughout the body.

But why is it called “broken heart’ syndrome?

symptoms of broken heart syndrome

How Does Broken Heart Syndrome Happen?

According to studies, severe physical and emotional stress could weaken the heart.

If your left ventricle weakens because of distressing events like natural disasters, loss of a loved one, severe sickness, or serious accidents, you could develop stress cardiomyopathy or Takotsubo cardiomyopathy.

Aside from the events mentioned above, here are the other stressors that could potentially cause symptoms of broken heart syndrome:

Physical Stressors

  • Asthma attack
  • Severe pain
  • Serious surgery
  • Medical procedures, such as cardiac stress test
  • A sudden drop in blood pressure

Emotional Stressors

  • Intense fear
  • Public speaking
  • Financial loss
  • A serious argument
  • Unexpected loss, sickness, or injury to a loved one
  • Receiving bad news

Even with the presence of this list, we still need more studies to determine the exact mechanism of the condition.

As of now, experts believe that the surge of stress hormones, like adrenaline, “stuns” the heart. This could cause changes in the heart cells or blood vessels or both.

Additionally, please note that this is not an exclusive list, so other stressors could also contribute to the development of Takotsubo cardiomyopathy.

Finally, some stressors are a combination of physical and emotional events, like domestic violence and car accidents. In essence, if an event “breaks your heart,’ it could result in stress-induced cardiomyopathy.

What are the Symptoms of Broken Heart Syndrome?

It’s important to know that the symptoms of broken heart syndrome is quite  similar to the signs of a heart attack. The following are the primary symptoms.

Chest Pain

People with stress-induced cardiomyopathy often experience chest pain or angina.

In fact, this is the most common symptom. Reports say that chest pain in Takotsubo cardiomyopathy can be described as “sudden and sharp,” similar to what a person having a heart attack experiences.

Is it Angina or a Heart Attack? Here’s How to Tell

Shortness of Breath

Difficulty breathing is also one of the signs of Takutsobo cardiomyopathy. It could also be accompanied by sweating, nausea, vomiting, and palpitations. If you’re wondering how palpitation feels like, it would seem like your heart is pounding, fluttering, or skipping a beat.


Like what happens during a heart attack, a person with stress cardiomyopathy may also experience loss of consciousness or fainting. Before this, they might also feel dizzy or weak.

How Do You Differentiate Heart Attack from Takotsubo?

Since the symptoms of broken heart syndrome are very similar to the signs of heart attack, there’s no way to tell the difference until doctors perform further testing.

The tests include:

  • Angiogram. An angiogram is an imaging test meant to see the insides of the blood vessels. If a person’s angiogram results do not show blockages in the coronary arteries, they can breathe a little easier.
  • Check for cardiac biomarkers. Cardiac biomarkers are substances seen in the blood when there’s damage to the heart. The biomarkers of a person suffering from a heart attack take a longer time to rise, but the peak is higher. In stress-induced cardiomyopathy, there’s only a “rapid and small rise’ in the biomarkers.
  • Echocardiogram. Another imaging test, an echocardiogram of someone who has Takotsubo would show the telltale apical ballooning. In other words, it will show that the left ventricle has assumed the shape of the octopus-trapping pot.

Because there’s no way of knowing whether you are suffering from Takotsubo or heart attack by merely looking at the signs and symptoms, you must see a doctor immediately when you experience chest pain, shortness of breath, and fainting.

Heart Attack Symptoms in Women vs Men: What’s The Difference?

Can You Prevent the Broken Heart Syndrome?

The truth is, there are no definitive preventive measures for stress-induced cardiomyopathy. However, you could still try to do the following.

Recognize and Manage Stress

Despite the lack of scientific studies, experts highlight the importance of stress management since distressing events often cause the condition.

Aside from doing stress-reducing activities, like relaxation techniques, you could also try recognizing the symptoms of stress. In doing so, you would be more prepared to manage it.

Know if You Are at Risk

It would also help to know if you are at risk of developing the symptoms of broken heart syndrome. According to reports, women are 8 to 9 times more likely to suffer from Takotsubo than men.

Interestingly, the risk heightens after a woman experiences menopause. That is why the majority of Takotsubo patients are women in their 60s.

Because of hormonal changes, post-menopausal women often have a decreased level of estrogen compared to younger ladies. This is an important idea since estrogen can protect the heart against stress hormones.

Lastly, although post-menopausal women are at higher risk, men and younger women could also suffer from stress-induced cardiomyopathy.


If you already suffered from stress-induced cardiomyopathy, the doctor might recommend long-term treatment involving medications. The medications could be beta-blockers or something similar that would protect the heart from the dangers of stress hormones.

Is Takotsubo Cardiomyopathy Fatal?

Most people do. The heart muscles may heal within 2 to 4 weeks and the majority of the patients make full recovery in 2 months. During your recovery, however, you may need regular check-ups and imaging tests to see your heart’s status.

In rare cases, broken heart syndrome could be fatal. It could also result in some complications including low blood pressure, heart failure, and the presence of fluid in the lungs. Always be aware of symptoms of broken heart syndrome and report to your physician immediately.

Lifestyle Changes to Improve Your Heart Health

Key Takeaways

Takotsubo cardiomyopathy commonly affects post-menopausal women, but it could also affect men and younger women. Although its symptoms are worrying, the prognosis, or chances of recovery, is quite good.

However, since there’s no way of knowing if you are experiencing the symptoms of broken heart syndrome or the signs of a heart attack, it’s important to seek medical help if you suffer from chest pain, shortness of breath, or fainting.

Learn more about Heart Health here. 


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Mia Dacumos, MD

Nephrology · Makati Medical Center

Written by Lorraine Bunag, R.N. · Updated Jun 10, 2021

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