The Science of Broken Heart Syndrome

No doubt, a breakup is one of the worst pains you can experience. But did you know parting ways with a lover can hurt so much that it actually causes symptoms similar to those of a heart attack? When this happens it's a condition known as broken heart syndrome, and ending a relationship isn't the only catalyst.

Here's what you need to know about broken heart syndrome, plus other (less serious, but just as real) physiological reasons you could be experiencing physical pain post-breakup.

What Is Broken Heart Syndrome?

Medically known as "stress-induced cardiomyopathy" or "tako tsubo cardiomyopathy," broken heart syndrome is a condition marked by a temporary weakness of the left ventricle of the heart in response to stress, explains Jennifer Haythe M.D., associate professor of medicine in the Center for Advanced Cardiac Care at Columbia University Irving Medical Center and co-director of the Columbia Women's Heart Center.

"That stress can be physical, like in the form of extreme temperatures or infection," says Dr. Haythe. Or, it can be emotional stress due to anything from the death of a loved one or job loss to divorce or heartbreak.

Typically, broken heart syndrome occurs within minutes of the stressful event, and usually resolves itself within four weeks, she says. (

How Broken Heart Syndrome Occurs

"The precise mechanism for why broken heart syndrome happens is not known," says Dr. Haythe.

Physiologically, the body responds to severe stress by releasing an influx of stress hormones and chemicals such as cortisol, adrenaline, and catecholamines, she says. The hypothesis is that following an extremely stressful event (i.e. a breakup), the volume of these hormones in the body is enough to shock the heart, temporarily weakening the heart muscle.

An echocardiogram (ultrasound image) or other imaging technique can be used to look at the heart and may show abnormal movements, according to Harvard Medical School Publishing. The most common abnormality seen in the case of broken heart syndrome is a ballooning of the lower left ventricle, making it look like a tako-tsubo (a pot used by Japanese fishermen to trap octopuses), which is how the syndrome got its name.

Broken Heart Syndrome vs. Heart Attack

The difference between broken heart syndrome and a heart attack is that with a heart attack there is either a complete or partial blockage in an artery (or arteries), says cardiologist Nicole Harkin, M.D., F.A.C.C., founder of Whole Heart Cardiology in San Francisco, CA. This starves the heart of nutrients and blood flow, which can damage the heart muscle.

With broken heart syndrome, there is reduced blood flow and a part of the heart may temporarily stop pumping blood as well, but there are no blocked arteries, she says. And only part of the heart is handicapped — the rest of your heart functions normally or with even more powerful contractions, according to the American Heart Association (AHA).

An important difference between a heart attack and broken heart syndrome is the aftermath: Data shows that 12 percent of people who have a heart attack will die from it, and 20 percent of heart attack patients will experience a second heart attack within five years, according to the AHA. On the flip side, estimates suggest that death from broken heart syndrome is rare, with one doctor saying that only 1 to 2 percent of people will die as a result. Overall, the effects on the heart during broken heart syndrome are temporary and usually completely reversible with proper prognosis, according to Dr. Haythe.

How to Know If You're Experiencing Broken Heart Syndrome

Symptoms of Broken Heart Syndrome

The symptoms of broken heart syndrome are very similar to that of a panic attack and are the same as the symptoms of a heart attack, says Dr. Haythe. In fact, "if a patient with tako tsubo cardiomyopathy has an electrocardiogram (EKG), the change resembles those of a heart attack, and they could even develop heart failure," she says. Possible symptoms include:

• Chest pain
• Shortness of breath
• Irregular heartbeat
• Low blood pressure
• Sweating

However, you can't know from the symptoms alone whether you're experiencing broken heart syndrome, having a heart attack, or enduring some other cardiovascular trauma. "If you feel any new symptoms in your chest or have crushing chest pain or shortness of breath please go to the emergency room," says Dr. Haythe. A doctor there will be able to check the heart to see if there are artery blockages or not.

If it's believed the patient is experiencing broken heart syndrome, typically the doctor will administer similar drugs to those a heart attack patient would receive, says Nicole Weinberg, M.D., a cardiologist at Providence Saint John's Health Center in Santa Monica, CA. "Beta-blockers and nitrates are used to help increase blood flow," to and from the heart, she says.

Because broken heart syndrome is an extreme response to anxiety, anti-anxiety medications may also be prescribed for stress management purposes.

Not All Breakup-Induced Pain Is Broken Heart Syndrome

While it's completely possible to experience broken heart syndrome due to a stressful breakup or heartbreak, it's actually not very common, says Dr. Harkin. One estimate cited by the Cleveland Clinic suggests that about 12,000 people might experience broken heart syndrome in a given year — that's roughly 1 percent of people who have a heart attack. It's most common in patients 50 and older, especially women. (Broken heart syndrome is thought to be most common in post-menopausal women due to the hormonal changes the accompany menopause, adds Dr. Harkin.)

That said, you may be experiencing other physical pain associated with heartbreak, even if it's not caused by broken heart syndrome specifically. Sometimes that pain is neuromuscular, neurological, or hormonal.

Neuromuscular Pain

Often, the chest pain that accompanies heartbreak is neuromuscular. "When you're in stressful situations (such as during heartbreak), you contract and tense your muscles," says Dr. Harkin. Doing so for an extended period of time can lead to muscle tightness — and this is true even with the muscles around the chest.

Unfortunately, tight chest muscles cause symptoms that are similar to both a heart attack and broken heart syndrome, according to Dr. Weinberg, such as:

• Shortness of breath
• Increased heart rate
• Chest pressure

"Chest muscle tightness will also likely cause tenderness of the muscle itself, so touching the skin above your heart may feel like touching a mild bruise," she says.

If stress is the cause of the chest pain, any stress-reduction tactics (exercise, yoga, meditation, etc.) will reduce the chest pain, says Dr. Harkin.

However, because the symptoms of stress-induced chest muscle tightness are so similar to symptoms of more serious coronary issues, it's best to get your symptoms evaluated by the doctor.

Neurological Pain

Interesting (but sad) fact: One 2011 study published in the Proceedings of the National Academy of Sciences of the United States of America found that when people viewed a photo of a former lover, they experienced the same brain activity as they did when they burned their arm.

"Experiences of social rejection, when elicited powerfully enough, recruit brain regions involved in both the affective and sensory components of physical pain," wrote the researchers. While not specific to chest pain, this shows that emotional pain — and more specifically, social and romantic rejection — creates the same bodily responses as a physical injury. (That's partially why dating apps can suck so much.)

Hormonal Pain

Broken heart syndrome isn't the only time there's hormonal havoc after heartbreak. Research shows that when you're falling out of love, your levels of "happy" hormones including dopamine and oxytocin dip while cortisol levels rise, according to Queensland Health, an official website by the Australian government.

Even if the increase in cortisol isn't enough to shock the heart (and induce broken heart syndrome), this combination of decreasing and increasing hormones can lead to a number of physically uncomfortable symptoms, including chest tenderness, stress, nausea, acne, and weight gain, says Dr. Weinberg.

"Sometimes the pain and sadness of heartbreak can cause noticeable symptoms, even if they aren't medically life-threatening," she says. "Still, that doesn't mean they're not real."