December 24th, 2008
09:30 AM ET

Broken heart syndrome

By Karen Denice
CNN Medical Senior Producer

As a medical producer I’ve become a bit of a de facto health adviser to my family. Usually it’s about knee pain or headaches, minor stuff. Unfortunately a few weeks ago it was major – my mother was feeling fatigued, coughing frequently and her heart ached. I was worried, but thought it might just be grief. Her brother had died suddenly just days before and anyone who has dealt with the death of a loved one knows it feels like your heart is physically breaking.

Marie Denice and Karen Denice

Marie Denice and Karen Denice

I’m lucky that my parents are great “empowered patients” and so now in their 70s they work hard to remain in good health. So after some prodding, my mom went to her doctor, who didn’t like the sound of things and sent her to a cardiologist. The cardiologist already had a baseline EKG for her, so when he did another he knew something was wrong. My mom called. “The doctor said I had a heart attack,” and she was going in the next day for an angiogram. Those words still shock me.

Luckily, rational thought returned, and I remembered a story we’d done a couple of years ago on a condition called "broken heart syndrome". It looks like a classic heart attack with an abnormal EKG, chest pain, fatigue etc., but doctors have discovered it is far less damaging to the heart. The New England Journal of Medicine published a study that found stress cardiomyopathy, or broken heart syndrome, can occur when someone, often older women, receive shocking news. The emotional impact of that news can set off a powerful chain reaction – adrenalin and other stress hormones surge – stunning the heart. While this syndrome is still a bit of a mystery, the good news is, doctors believe that, unlike a heart attack, there is usually no long-term impact on the heart.

I e-mailed my mother the study and other articles, hoping this is what she had, hoping there was no damage to her heart. But her angiogram would tell the tale – showing any blockages or damage. Thank goodness, she came out with a clean bill of health and the doctor diagnosed stress cardiomyopathy. Phew!

Days later she went back to her primary care physician to tell him the good news and brought the research I’d sent her. The doctor had never heard of broken heart syndrome. This is an important point for everyone who comes to CNNhealth and is a health consumer. In this state of health care, primary doctors often don’t have time to read all the medical journals and research out there. So, empower yourself and if you suspect your symptoms are something other than what they say – speak up and talk it over with your doctor.

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soundoff (22 Responses)
  1. DrD11

    "Broken Heart Syndrome",applies also to people who suffer Sudden
    Cardiac Arrest.It has been demonstrated,radiogrfically,how the heart"Breaks",during Ventricular Fibrillation.
    Once the heart electrical activity returns to normal,the "Broken Heart"
    starts to heal itself.The Congestive Heart Failure starts to fizzle.
    Conclusion:The faster one pulls a failing heart out of Ventricular Fibrillation,the better it is.

    December 24, 2008 at 12:51 | Report abuse | Reply
  2. Haris

    It never ceases to amaze that responsible news organization as CNN and others will write so irresponsible articles. The author writes

    "In this state of health care, primary doctors often don’t have time to read all the medical journals and research out there. So, empower yourself and if you suspect your symptoms are something other than what they say – speak up and talk it over with your doctor"
    So let me get this straight the author is telling people, don't listen to the person who went to medical school and then trained for years to take care of patients and are required to keep up-to-date with continuing medical education. Rather, you are better off consulting de facto health advisers like Ms. Denice.
    As a cardiologist in training, I strongly feel that Ms. Denice owes an apology to her mother's primary care. The diagnosis of broken heart is a diagnosis of exclusion (i.e. you refer the patient to the cardiologist and then an angiogram should be done if it is indicated). The primary care doctor did exactly what any responsible physician should have done, referred the patient to a cardiologist to make sure that there was nothing dangerous (big heart attack) going on, rather than focusiing on a rare syndrome. Her mother could have been having a heart attack which could be potentially life threatening and may have been saved by timely intervention.
    Don't get me wrong, patient have the right to ask questions, know what is going on and decide on their treatment options. But, please know when to be critical of the healthcare system on appropriate times, rather than just publishing articles which may have no real sense.

    December 25, 2008 at 00:37 | Report abuse | Reply
  3. S. Barr

    What a great read this was. I believe it to be true, that this does happen. Thank you for sharing this.

    December 26, 2008 at 02:00 | Report abuse | Reply
  4. K. Kennedy

    To young doctor-in-training Haris: I hope that you overcome your medical arrogance before you begin practice. What Ms. Denice says is absolutely true. Even the smartest doctors are very busy. They have huge caseloads and limited time to spend on any one patient.

    Patients of course need to listen to their doctors, but they also need to arm themselves with the knowledge to ask intelligent questions and relate their doctor's advice to their own circumstances.

    I could cite many examples of a patient alerting a doctor to a problem that might otherwise have been overlooked. The medical relationship should be an equal partnership between doctor and patient, with respect on both sides.

    The doctor is not an all-knowing diety, but an educated advisor. He or she is the expert on medicine, but the patient is the expert on his or her own symptoms and circumstances.

    Personally, I would not want to be your patient until you have had enough years of real-world experience to gain true wisdom. Right now you only have facts.

    December 26, 2008 at 11:45 | Report abuse | Reply
  5. S Callahan

    I can identify with this...back in 1996 I had some serious rhythm issues with heart....and it started right after my sister 's car accident which left her severly brian injured and paralyzed . This was heartbreaking to 'lose' her this way (she's still alive)..over time and acceptance of the new person she is ..the rhythm seem to correct itself.......
    My Mom died only months after her baby (in his 70's ) brother died...I know that impacted her..

    December 26, 2008 at 21:28 | Report abuse | Reply
  6. IYM

    Yup I agree with Haris.. we doctors go by symptoms and then come up with a list of differential diagnoses and depending on our clinical suspicion we make appropriate referrals in order for the appropriate work up to be carried out by the specialist so a final diagnosis can be made before targeting our managment.

    Being an a High-Risk Pregnancy fellow, I usually get appropriate and timely referrals more than 99 % of the time.

    I had a pregnant patient once with the 'Broken Heart Syndrome'; and it was Cardiology service in the CCU who made the diagnosis; that is their area of expertise anyways. And yes it was the first time I hear about such a condition. It doesn't mean I don't update myself, I do in fact but in my area of expertise which is OBGYN and High-Risk Pregnancy. The patient was sick enough to consult cardiology and they've done their job properly and efficiently.

    It's OK for patients to surfe the internet looking for infos and all, and we recieve phone calls almost on daily basis from concerned patients just clarifying and rectifying some false knowledge that they've acquired by just browsing the net. One of our jobs is to educate patients and that's what this site is doing. However I'll be careful about comments that can break doctor-patient trust like the one made in this article that Haris has pinpointed to. After all, the primary care physician has done his job properly by referring the patient to cardiology which was all she needed at the time.

    Good day all..

    December 27, 2008 at 13:46 | Report abuse | Reply
  7. Virginia Ann McHugh

    Really good article...speaks to me directly.
    Only wish I could "print" it out...I save articles of interest. Thanks. V.

    January 2, 2009 at 08:28 | Report abuse | Reply
  8. Julescharm

    Thank you so much, since going into hopital for a suspected "heart attack", my ECG showed that I was having a massive attack, although I only had shoulder pain and was well in myself,unfortunately, blood taken also showed I had received damage to the muscle.
    The next day I had a angiogram and was asked if anything had happened on the day of the attack, I had no shock but had been under a considerable amount of pressure and stress for some time and that day also overdid my workload. I was told "good news" all your arteries are clear and it was "Brokenheart syndrome". Unfortunately, a couple of hours later, a Doctor on the ward who didnt seem to have much faith in what the specialist had diagnosed and said because I had damage I must have had a heart attack. I still remain confused to this day, exactly what happened, they are treating me with all the heart tablets and will have a follow-up with the specialist in 3 months time. My Doctor and no-one seems to know about Broken heart syndrome and quite honestly, they dont seem interested either and I need to know. !! All my results showed very mild and very small amount of damage and I had a stress test and other tests and my heart coped well. I am looking forward to going to the specialist because some doctors will not accept Brokenheart syndrome as a "heart condition" and would rather just label it a heart attack.

    January 6, 2009 at 09:48 | Report abuse | Reply
  9. annalise leiter

    Medical research tells us over & over that one's state of mind
    has physiological impacts on our bodies. Broken heart
    syndrome probably affects anyone experiencing great personal
    stress. When my young adult child died suddenly, with no prior
    health concerns, whatever I felt then and feel now is focused in
    my chest. Identifying my body's reaction to grief, loss, and despair
    as 'broken heart syndrome' seems perfectly reasonable to me.

    January 6, 2009 at 16:30 | Report abuse | Reply
  10. Marcia Atlas

    Last December 2008, I was diagnosed at first with a heart attack. It happened at school when I was teaching. I had an EKG and an angiogram which showed no blockage. However, 60 percent of my heart had been stunned by stress hormones and was not pumping. I was diagnosed with broken heart syndrome by the interventional cardiologist the following day. He was very happy and said that eventually I would be back to normal. It took about 6-8 weeks, but my heart did normalize. I now tke a beta blocker daily. Those first 3 days were extremely frightening.

    January 14, 2009 at 18:24 | Report abuse | Reply
  11. Century2119

    Just wonder if any one following up with people whom had heart broken syndrome?like to get update. Thanks

    November 15, 2011 at 12:03 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.