Have you ever had your heart broken? It hurts, doesn’t it. But there’s actually a real medical condition called “broken heart syndrome," that refers to a weakening of the muscles of the heart. This can cause a part of the heart to temporarily swell. This means the heart is not able to pump well.

What causes a broken heart syndrome?

As the name suggests, a broken heart syndrome has been associated with intense emotional stress, like losing a loved one, or intense physical stress, such as being admitted with severe disease in the ICU. For this reason, it is also known as stress cardiomyopathy. The body’s normal response under any stressful situation is to release a lot of different hormones to help the heart beat faster and stronger. Some have suggested this can cause the weakening of the muscles of the heart, resulting in the broken heart syndrome.

What happens to the heart muscles in broken heart syndrome?

As mentioned above, the weakening of the heart muscle can cause a part of the heart can swell up like a balloon. With every heartbeat, the parts that are weak are unable to contract. This gives it a unique appearance on echocardiography (ultrasound of the heart), like that of a balloon. This resembles an octopus trap (round wide base, narrow neck), called tako-tsubo in Japanese. For this reason, broken heart syndrome is also called Takotsubo cardiomyopathy, a term coined in Japan.

What are the symptoms of broken heart syndrome?

Symptoms are similar to that of a heart attack and heart failure. The most common ones include

• Chest pain: this can be sudden and severe in onset

• Shortness of breath: with regular activity or especially while lying flat, waking up in the middle of the night gasping for air. In severe cases, some may only get sleep when propped up on multiple pillows, or sitting up

• Passing out: This can be due to irregular heartbeats, which are not effective in pumping blood

Symptoms may occur anywhere from a few minutes to a few hours after a stressful situation. In severe cases, some patients can go into a shock due to inadequate pumping function of the heart.

How is broken heart syndrome managed?

Emergency care should always be sought immediately for sudden onset chest pain or worsening shortness of breath. Apart from getting an EKG, echocardiogram (ultrasound of the heart) and some blood tests, it is important to rule out any possible blockages in the arteries of the heart that may be causing the presenting symptoms. A coronary angiogram is a special X-ray test to analyze whether the coronary arteries are blocked or narrowed, and by how much. Often, the coronary angiogram is done before other tests to make sure the blockages can be addressed as soon as possible.

The condition usually resolves within a couple of months, with recovery of the heart function. If fluid congestion is present in the lungs, a “water pill” (Furosemide) may be given to help with the breathing. Other heart failure medications may be given to help with the recovery of the weakened heart muscles, such as beta-blockers and angiotensin-converting enzyme inhibitor.