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Study Suggests You Can Die of a Broken Heart

Stress Hormones Cause Fatal Spasms, Scientists Find

By Rob Stein
Washington Post Staff Writer
Thursday, February 10, 2005; Page A03

As Valentine's Day approaches, scientists have confirmed the lament of countless love sonnets and romance novels: People really can die of a broken heart, and the researchers now think they know why.

A traumatic breakup, the death of a loved one or even the shock of a surprise party can unleash a flood of stress hormones that can stun the heart, causing sudden, life-threatening heart spasms in otherwise healthy people, researchers reported yesterday.

Sylvia Creamer of Walkersville, Md., developed severe chest pain after giving an emotional talk about her son's mental illness. She had an unusual heart malfunction, not a heart attack, as doctors first thought. (Ricky Carioti -- The Washington Post)

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The phenomenon can trigger what seems like a classic heart attack and can put victims at risk for potentially severe complications and even death, the researchers found. By giving proper medical care, however, doctors can mend the physical aspect of a "broken heart" and avoid long-term damage.

"When you think about people who have died of a 'broken heart,' there are probably several ways that can happen," said Ilan S. Wittstein of the Johns Hopkins School of Medicine in Baltimore, whose findings appear in today's New England Journal of Medicine. "A broken heart can kill you, and this may be one way."

No one knows how often it happens, but the researchers suspect it is more frequent than most doctors realize -- primarily among older women -- and is usually mistaken for a traditional heart attack.

That is what happened to Sylvia Creamer, 73, of Walkersville, Md., who experienced sudden, intense chest pain after giving an emotional talk about her son's battle with mental illness.

"I started having this heavy sensation just pushing down on my chest," said Creamer, who was taken to a hospital where doctors began treating her for what they thought was a heart attack. But Creamer's arteries were fine, and Wittstein and his colleagues subsequently determined that she had instead experienced an unusual heart malfunction. She quickly recovered.

The idea that someone can die from a broken heart has long been the subject of folklore, soap operas and literature. Researchers have known that stress can trigger heart attacks in people prone to them, and a syndrome resembling a heart attack in otherwise healthy people after acute emotional stress has been reported in Japan. But very little was known about the phenomenon in this country, and no one had any idea how it happened.

The new insight is perhaps the most striking example of the link between mind and body, several experts said.

"This is another in a long line of accumulating, well-documented effects of stress on the body," said Herbert Benson, a mind-body researcher at Harvard Medical School. "Stress must be viewed as a disease-causing entity."

The findings also underscore the growing realization that there are fundamental physiological differences between men and women, including how they respond to stress.

"This is why we need to do more research involving women," said cardiologist Deborah Barbour, speaking on behalf of the American Heart Association. "We can't extrapolate a man's response to a woman."

It remains unclear why women would be more vulnerable, but it may have something to do with hormones or how their brains are wired to their hearts.

"Women react differently to stress, particularly emotional stress. We see that in our daily lives," said Scott W. Sharkey of the Minneapolis Heart Institute, who described 22 similar cases last week in the journal Circulation.

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