Our mental health and physical health are inextricably linked. People often stress the direct links between the chemicals in our brains and the GI system, but the mind-heart connection is just as strong. Stress can have a long-term impact on our hearts, and when it comes in extreme waves, as it does during traumatic events, the results often aren’t great—this is also called “broken heart syndrome.” There are two basic categories of heartache-induced heart problems: Direct physiological impact and indirect impacts that come in the wake of the event. Here’s what you need to know.
Broken heart syndrome is real
Broken Heart Syndrome, known to doctors as takotsubo cardiomyopathy, occurs when someone experiences a huge surge of negative emotions. It’s a primal response, linked to humans’ earliest years as hunter-gatherers, but it’s just as dangerous now as it was millennia ago. “When someone is very upset or very scared, when there’s a highly emotional event, it releases a huge release of stress hormones, and the rush of those stress hormones overwhelms the heart,” saysDr. Suzanne Steinbaum, volunteer medical expert for American Heart Association’s Go Red for Women movement and cardiologist in New York City. “The heart becomes stunned and it almost looks like there’s a heart attack,” Dr. Steinbaum says. “The heart basically stops moving and the EKG looks as if a person’s having a heart attack, but they’re not. The stress hormones just absolutely oversaturate and overwhelm the heart and cause the heart to sort of get broken.” Three hormones in particular are triggered in this reaction: Cortisol, norepinephrine, and epinephrine (also known as adrenaline). Dr. Steinbaum explains that the stress from a breakup or other piece of devastating news causes the brain to tell the kidneys to release the hormones, which flow directly to receptors on the heart. Known as “fight or flight” hormones, they’re a good thing if you’re being chased or threatened, or even competing in a sporting event, but they’re not so helpful if you’re not in any actual peril or don’t need a rush of energy. Cortisol creates inflammation, while norepinephrine and epinephrine speed up the heartbeat. As Dr. Steinbaum explains it, the flood of these “fight or flight” hormones leads to arteries “clamping down,” which leads to the heart seeming like it has totally shut down. This is obviously dangerous—Dr. Steinbaum says she’s had a handful of patients rushed to the hospital, so those feeling symptoms should seek medical care while Heartbreak Syndrome is in its acute phase. “Usually, the initial diagnosis of stress-induced cardiomyopathy is the abrupt onset of symptoms that include shortness of breath and chest pain,” addsDr. Marcus St. John, an interventional cardiologist with Miami Cardiac & Vascular Institute. “These are often accompanied by elevations of heart enzymes and changes in the EKG that can mimic a heart attack.” The good news is that, just as a metaphorical broken heart can mend, the real thing can also heal with time. It’s a “reversible cause of weakness to the heart muscle,” Dr. St. John says, given rest and rehabilitation. Dr. Steinbaum suggests three months as a viable timetable for that process. But without the correct course of action, ongoing stress can cause ongoing problems for the heart. “We all experience stress from time to time, but chronic stress, without the inflammation-lowering effects of what we call ‘buffers,’ can have toxic consequences on your heart, brain, and other organs,” says Dr. Jonathan Goldfinger, MD, MPH, FAAP, and the CEO of Didi Hirsch Mental Health Services in Los Angeles. “In fact, there’s a clear connection between chronic inflammation, depression and heart disease. If you understand that the inflammation of chronic stress is poisoning your body, and can even be deadly from a heart attack, stroke or even suicide, you are hopefully more likely to learn and practice seven proven buffers of toxic stress.”
How to manage heartbreak so you can take better care of your heart
We’ve all been there—devastated by a breakup or job loss, moping around the house, eating chocolate or some other guilty pleasure food to help soothe the pain. And hey, if it helps us feel better for the first few days, that’s a good thing—higher levels of stress, as we’ve seen, are very dangerous for the heart. The problem comes when the stress doesn’t go away and instead becomes chronic. Not only does that place an ongoing burden on the heart, weakening it with inflammation, it also leads to what Dr. Goldfinger calls “maladaptive behaviors,” which is another way of saying bad habits that can create compounding health difficulties. “Researchers believe chronic stress contributes to heart disease through both uncontrolled inflammation and certain maladaptive behaviors humans are prone to during times of stress like smoking, overeating and overuse of alcohol or substances, which then add to the inflammation,” Dr. Goldfinger says. “Combined, these contribute to heart disease by damaging the walls of small blood vessels feeding the heart and large vessels carrying pumped blood out to the brain and body." So, how does one prevent getting a damaged heart from a broken heart? As Dr. Steinbaum says, it’s about sticking to the basics of self-care: exercise, eating right, sleeping, and managing stress. “Our minds and bodies are inseparable,” Dr. Goldfinger says. Next, is it a heart attack or a panic attack? Here are some easy ways to tell the difference. Sources:
Harvard Health Publishing, Harvard Medical School: “Understanding the stress response"Suzanne Steinbaum, volunteer medical expert for American Heart Association’s Go Red for Women movement and cardiologist in New York City.Jonathan Goldfinger, MD, MPH, FAAP, and the CEO of Didi Hirsch Mental Health Services in Los AngelesDr. Marcus St. John, an interventional cardiologist with Miami Cardiac & Vascular Institute
