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Broken Heart Syndrome Can Be Caused by Grief or other Extreme Stressors

Updated: Feb 1

- Teresa Jacobson, DBH, LPCC-S, NCC

November 15, 2021

Broken Heart Syndrome results when a person's heart changes shape causing intense chest pain and various other symptoms of a heart attack. Takotsubo cardiomyopathy is the technical name for this unique cardiac condition that does not result from clogged arteries. Commonly referred to as Broken Heart Syndrome, this condition occurs in response to grief after a deeply loved person dies, or other extreme physical and/or emotional stressors.

"Takotsubo cardiomyopathy is a genuine physiologic condition that was first described in medical literature 30 years ago" (Boyd & Solh, 2020). "The condition also is known as broken heart syndrome, stress cardiomyopathy, and apical ballooning syndrome. These names describe a syndrome in which severe emotional or physical stress causes the left ventricle to dilate, leading to transient acute heart failure."

Signs and symptoms of Broken Heart Syndrome are similar to that of myocardial infarction or heart attacks. Both physical and emotional stressors can trigger Takotsubo cardiomyopathy.

"The most commonly identified physical triggers of Takotsubo cardiomyopathy include surgery and acute respiratory failure" (Boyd & Solh, 2020). Boyd and Solh continue to report: "The most common emotional triggers are death of a loved one, relationship conflicts, fear, anger, and anxiety." The syndrome is more prevalent in women.

Due to the physiological and emotional involvement of triggers, the "adrenergic system" is suspected to be involved in the pathophysiology. Estrogen is also suspected to play a role.

Grief, Toxic Stress, Panic, and Anxiety are Risk Factors

"Worldwide, about 90% of patients with Takotsubo cardiomyopahy are women--most of whom are postmenopausal" (Boyd & Solh, 2020). Panic disorder and anxiety are also considered to be risk factors. Research shows that 55.8% of patients with Broken Heart Syndrome had a history of neurologic or psychiatric disorders.

The recovery is favorable at 95% of patients recovering full cardiac functioning within a few weeks (Koulouris et al., 2010). "Prognosis is good, with full recovery of cardiac function within 2-4 weeks in most of the cases."

Patients who experience chest pain and shortness of breath after severe emotional or physical stress should be evaluated at the hospital. Electrocardiogram will show abnormalities "that mimic those of a heart attack" without evidence of coronary artery obstruction and ballooning of the left ventricle, but a coronary angiography is needed to establish diagnosis (Harvard Health, 2020).

Brain Body Connection

"It's clear there's a brain-heart connection when you look at broken heart syndrome" reported Dr. Susan Cheng in a recent Today health and wellness article (Pawlowski, 2021). The article also reports that cases of broken heart syndrome have been on the rise since the pandemic began due to the stresses of the crisis, "not as a health hazard from the virus itself".

Stress impacts the mind and the body in many ways. With broken heart syndrome, the treatment is to remove the source of stress if possible and follow protocol offered by medical providers, which could include medication, and other therapeutic modalities.

If you or a loved one is experiencing extreme stressors or toxic stress, it is vital to seek out all possible support and stress management to cope in a healthy way. Counseling can be a helpful step towards mending a broken heart.


Teresa Jacobson is a Doctor of Behavioral Health and Licensed Professional Clinical Counselor Supervisor who is counseling Ohio and Kentucky adults of all ages and life experiences via secure Telehealth/Video visits. A strength-based, person-centered multi-cultural counselor, with an existential philosophy, Teresa can be reached by emailing, calling (513) 206-3026, or visiting



Boyd, B. (2020). Takotsubo cardiomyopathy: Review of broken heart syndrome. Journal of the

American Academy of PAs. 33(3) 24-29.

Harvard Health Publishing (2020). Takotsubo cardiomyopathy (broken-heart syndrome). Retrieved


Koulouris, S., Pastromas, S, Sakellariou, D., Kratimenos, T, Piperopoulos, P., and Manolis, A.S. (2010).

Takotsubo Cardiomyopathy: "The Broken Heart" syndrome. Hellenic Journal of Cardiology,


Pawlowski, A. (2021, November 11). Broken heart syndrome on the rise for women over 50, study finds.

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