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A broken heart or a heart attack — here's how to tell the difference

Andrea Michelson   

A broken heart or a heart attack — here's how to tell the difference
  • Broken heart syndrome may cause chest pain and shortness of breath after a stressful event.
  • The symptoms may look similar to a heart attack, but the underlying problem is different.

Harmony Reynolds, a cardiologist at New York University Langone, has seen multiple people heal from a broken heart.

"I've seen this in somebody who was under a car, fixing the car, and it almost fell on him," she said. The man developed broken heart syndrome, a rare and usually temporary heart disorder that's brought on by stress both physical and emotional.

Reynolds in an expert on broken heart syndrome — also called takotsubo cardiomyopathy, after an octopus trap that resembles the misshapen heart. The syndrome occurs when a rush of stress hormones temporarily stuns part of the heart muscle and causes the organ to beat irregularly.

Broken heart syndrome may look the same as a heart attack at first, and it's possible to die of a broken heart. But a heart attack is far more likely to be fatal compared to the rare syndrome, Reynolds told Insider.

Both emotional and physical stress can trigger broken heart syndrome

About one-third of broken heart patients can point to an emotional stressor that triggered the syndrome, like an unexpected death or traumatic event, Reynolds said.

"I've seen it from near-miss car accidents," she said. "I have treated somebody who was very concerned about a family member, even though that family member proved to be okay."

Reynolds said even a joyful moment can set off the syndrome. "Broken heart syndrome is sometimes happy heart syndrome," she said. "It's occasionally triggered by happy events, like a wedding, or getting really good news."

Physical stressors, such as severe illness or sudden injury, cause another third of broken heart syndrome cases. Reynolds said exercising at high altitudes or intensity also can push someone to the limits of their stress tolerance, as could surgery or a stroke.

The remaining third of cases are attributed to a mixed bag of triggers, including the use of illegal stimulant drugs or certain prescription medications, according to Mayo Clinic.

Women are more likely than men to suffer broken heart syndrome

Women older than 50 are the population most often affected by broken heart syndrome, but men can develop the condition too, Reynolds said. The risk increases for people with a history of anxiety or depression, according to Cleveland Clinic.

Fortunately, broken heart syndrome is treatable and often heals on its own, Reynolds said. Most people who experience it make a full recovery within weeks, and they're at low risk for it happening again.

But stress can also trigger a heart attack — which is deadlier

Because the condition is associated with stress, Reynolds said some people assume that chest pain after a traumatic event must be a symptom of broken heart syndrome. However, severe stress can also trigger a regular heart attack, she said.

While broken heart syndrome has been known to resolve itself with time, heart attacks must be treated promptly to avoid long-term complications. Parts of the heart muscle can die if they are left without blood flow for too long, so even though the symptoms may be indistinguishable from broken heart syndrome, it's important to act with caution.

Reynold recommends that people seek medical attention if they ever feel pain or discomfort in the chest area — which may extend to the jaw, neck, shoulders, arms, back, and upper stomach — for 10 minutes or more.

"Just because you had a stressful event and then had chest pain, don't assume this is broken heart syndrome," Reynolds said. "There can be a missed opportunity to save somebody's life and salvage heart muscle."



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