How stress and anxiety may be “breaking” your heart


In this article:

  • Recent research showed an uptick in broken heart syndrome during the COVID-19 pandemic.

  • A 2020 study looked at more than 1,900 patients with broken heart syndrome and found that more patients experienced the syndrome during COVID-19.

  • A Providence cardiologist shares possible treatments.

There's no doubt that coronavirus (COVID-19) brought heaps of stress and anxiety into our lives. Many are still feeling a strain on their mental health as we continue to manage challenges caused by the pandemic and navigate a return to social activities.

But that stress may be affecting more than just our mental health. Recent research shows that anxiety around COVID-19 may be causing a spike in cases of broken heart syndrome.
Broken heart syndrome is a sudden cardiac event that has similar symptoms to a heart attack, including intense chest pain. It's caused by a sudden rush of hormones, which can be brought on by an extremely stressful event.

This condition is also sometimes called stress-induced cardiomyopathy or takotsubo cardiomyopathy. Fortunately, most people who experience broken heart syndrome can be treated and make a full recovery a few weeks after the event.

What research says about COVID-19 and broken heart syndrome

A recent study published in JAMA Network Open looked at patients who were diagnosed with broken heart syndrome at two hospitals in Ohio. The researchers studied the number of patients diagnosed with the syndrome during COVID-19 (March-April 2020). They compared it to patients diagnosed during four other, pre-pandemic periods (March-April 2019, January-February 2019, March-April 2019 and January-February 2020).

Researchers found that more patients were diagnosed with broken heart syndrome during the COVID-19 period. There were 20 patients diagnosed during COVID-19, compared to 5-12 patients diagnosed during the other periods.

The study also showed that broken heart syndrome patients diagnosed during COVID-19 stayed in the hospital longer compared to patients diagnosed before the pandemic. None of the patients who had broken heart syndrome during the pandemic tested positive for COVID-19.

"These findings suggest that psychological, social and economic stress related to the COVID-19 pandemic was associated with an increased incidence of stress cardiomyopathy," the study says.

What happens when someone has broken heart syndrome?

When you experience broken heart syndrome, part of your heart enlarges temporarily and doesn't pump blood correctly. Meanwhile, the rest of your heart pumps blood normally or uses stronger contractions to make up for the part of the heart that isn't working properly.

What causes broken heart syndrome?

In most cases, broken heart syndrome is prompted by an extremely stressful event, like a pandemic, which can cause a surge of stress hormones. Researchers are still looking into exactly how these hormones cause heart problems.

Stressful events that can prompt broken heart syndrome may include:

  • Death of a loved one
  • Divorce
  • Serious medical diagnosis
  • Major surgery
  • Car accident
  • Job loss
  • Domestic abuse
  • A traumatic event

In some cases, the rush of stress hormones can be caused by certain medicines that treat:

  • Allergic reactions, such as epinephrine (EpiPen)
  • Depression, such as duloxetine (Cymbalta) or venlafaxine (Effexor XR)
  • Thyroid problems, such as levothyroxine (Synthroid or Levoxyl)

What are the symptoms of broken heart syndrome?

Broken heart syndrome symptoms are similar to a heart attack. They usually include:

  • Sudden, intense chest pain
  • Shortness of breath
  • Irregular heartbeats (arrhythmias)

If you are having any of the above symptoms, call 911 immediately. Although it can be difficult to decipher a broken heart from a heart attack, it is best to get to a hospital and see a doctor quickly — he or she will be able to determine the exact cause of your symptoms and prescribe the right treatment.

The biggest difference between broken heart syndrome and a heart attack is that broken heart syndrome symptoms happen right after an extremely emotional event. Tests results also look different — when someone has broken heart syndrome, tests usually show no signs of heart damage or blockages in the arteries.

How is broken heart syndrome treated?

It is important to receive an accurate diagnosis from your doctor before starting treatment. If you suspect that you may have symptoms of broken heart syndrome, your doctor can order any necessary tests and discuss a treatment plan with you.

Does broken heart syndrome cause any serious side effects?

Most people recover from broken heart syndrome within a few weeks and don't have any lasting side effects. However, in rare cases, broken heart syndrome may cause complications like heart failure, irregular heartbeats, or even death.

So, whether you're feeling anxious about getting sick, stressed about quarantine, or overwhelmed with data or decision-making, keep in mind the warning signs of broken heart syndrome. While it may not be as dangerous as a heart attack, it is still vital that you seek treatment as soon as possible, so it doesn't lead to future complications. Finding creative and natural ways to cope with stress can also help reduce your risk of heart complications.


Find a doctor

When in doubt, don't hesitate to talk to a professional about the stress and anxiety you're feeling. They will be able to help you find healthy ways to cope.

You can also access Providence Express Care Virtual to connect face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow-up as needed. If you need to find a doctor, you can use our provider directory or search for one in your area.

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Related resources

Five ways to curb Coronavirus-related stress and anxiety

Is it stress, anxiety or panic?

Your heart: How to protect it from stress

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

About the Author

The Providence Heart & Vascular Team is committed to bringing you many years of expertise and experience to help you understand how to prevent, treat and recover from cardiovascular diseases and conditions. From tips to eating better to exercise and everything in between, our clinical experts know how to help you help your heart.

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