What are the symptoms and causes?

Two days after fourth-grade teacher Irma Garcia was killed in the Uvalde, Texas school shooting, her husband, Joe Garcia, also died suddenly. Family members attributed his death to a broken heart.

Irma Garcia’s nephew, John Martinez, said Joe collapsed at his home on Thursday shortly after delivering flowers for Irma’s memorial. Doctors have said sudden death following a tragedy could be evidence of broken heart syndrome, a rare condition that mimics a heart attack.

“Typically, when broken heart syndrome occurs, it’s after an extreme stressor,” said Dr. Deepak Bhatt, a cardiologist at Brigham and Women’s Hospital.

“It’s highly likely that the stress of his wife’s death was what triggered this,” he said.

But Dr. Harmony Reynolds, a cardiologist at NYU Langone, noted that traumatic events can also trigger fatal heart attacks.

“It’s much more likely that he just had a heart attack brought on by intense emotional distress,” she said.

What causes broken heart syndrome?

Heart attacks are caused by clogged arteries that cut off the blood supply to the heart. People with broken heart syndrome, on the other hand, release surges of stress hormones like adrenaline that prevent their heart from contracting properly. The condition is officially known as takotsubo cardiomyopathy.

According to the Cleveland Clinic, doctors have identified broken heart syndrome in about 2% of suspected heart attack patients. It often occurs shortly after a stressful event such as a car accident, financial loss, or the unexpected death of a loved one.

People can also develop broken heart syndrome after a positive, emotionally charged event like a surprise party or winning the lottery, or after a physical event like extreme exercise.

“Not all takotsubo syndromes are triggered by emotional or physical distress, but sometimes they are — about two-thirds of the time,” Reynolds said. Other times, she added, there is no trigger.

Bhatt said some people may experience broken heart syndrome minutes after bad news is announced, while others may take time to emotionally process a traumatic event.

“It can be hours later and in some cases a day later. Maybe it’s when someone realizes, ‘Oh, wow, my beloved is actually dead. They really aren’t coming back,” Bhatt said.

What are the symptoms of broken heart syndrome?

Unusual chest discomfort or shortness of breath following a stressful event can be an indication of broken heart syndrome, but there aren’t always warning signs, Bhatt said.

“If they’re new to symptoms, get medical help right away — usually by calling 911,” he said. “Unfortunately, sometimes the first manifestation of a heart attack is fatal, so not everyone has symptoms.”

From the outside, broken heart syndrome looks like a standard heart attack. Doctors use imaging tests to distinguish between the two and determine how to treat patients.

“For broken heart syndrome, there are no blocked arteries, so you would just manage the person with medication,” Bhatt said. “So from the doctor’s point of view, it’s really important to know what type it is, but from the point of view of the person who might have it, it’s a medical emergency either way.”

The condition is most common in women aged 50 and over: women accounted for about 88% of broken heart syndrome cases in a 2021 study. A 2020 study also found that anxiety disorders were more common in patients with broken heart syndrome than in healthy people.

Can you recover from broken heart syndrome?

About 1% of people with broken heart syndrome eventually die from it, according to the Cleveland Clinic. Many people make a full recovery in about a month and have no long-term heart damage.

Reynolds said there is no known method to prevent broken heart syndrome, although she is investigating whether deep breathing might help.

Doctors said maintaining good physical and mental health, even in the aftermath of a tragedy, is still important to lower the risk of heart disease.

“It’s always important to try to eat well, try to get enough sleep and try to control stress as much as possible, and seek help if needed,” Bhatt said.

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