Is it possible to perish from a broken heart?

The story of Dorothy Lee, an elderly woman, is not particularly unique. In 2010, The Wall Street Journal highlighted her experience: after discovering her husband of four decades had tragically died in a car crash, Lee began experiencing chest pains akin to a heart attack [source: Winslow]. Her body seemed to rebel against the shock of her sudden loss.

The death of a long-term spouse often triggers severe health issues or worsens existing conditions in the surviving partner. Numerous accounts describe husbands and wives passing away within days or weeks of each other, a phenomenon backed by research. Studies conducted in Scotland and Israel, involving thousands of couples, found that the mortality risk for widows and widowers spikes by 30 to 50 percent in the first six months following their partner's death [source: Dahlstrom]. This heightened risk gradually declines after the initial grieving period [source: Martikainen and Valkonen].

This profound mind-body connection seems more prevalent when a spouse's death is sudden and unexpected, leaving the surviving partner unprepared to face life alone. A 1996 study involving 158,000 Finnish couples revealed that the highest rates of excess mortality, or statistically unexpected deaths, were linked to the abrupt and accidental loss of a spouse [source: Martikainen and Valkonen]. Medical experts attribute this trend to chronic health issues, psychologists to grief-related stress, and social workers to the absence of a support network. Romantics, on the other hand, might poetically describe it as the consequence of a broken heart — and in certain instances, they might not be entirely wrong.

This was precisely what Dorothy Lee went through on the day her husband passed away. Her chest pains, as it turned out, weren’t caused by arterial blockages but by a condition known as takotsubo cardiomyopathy, or broken heart syndrome.

Love Hurts, Literally

Broken heart syndrome was first identified by Japanese doctors in the early 1990s when they observed five unique patients among 415 heart attack cases. Unlike the others, these patients had no arterial blockages, the typical cause of heart attacks, and they recovered faster and more easily [source: Dote et al]. Upon further examination, doctors discovered that the left ventricles of their hearts had swollen, resembling a takotsubo, a pot used for trapping octopuses [source: Derrick]. This swelling increased pressure on the heart, leading to temporary heart attack-like symptoms. In 2005, studies linked these pseudo-heart attacks to intense emotional states like grief, anxiety, and stress, earning the condition its poetic nickname.

Broken heart syndrome is a rare but striking example of how emotional pain impacts physical health. Even mild emotional distress, such as rejection or loss, doesn’t just affect the mind but also manifests physically. The brain interprets this pain as physical discomfort and activates inflammatory stress responses, causing symptoms like sweaty palms, a racing heart, and rapid breathing [source: Hendrick]. Brain imaging studies show that the same neural pathways are activated by the pain of a breakup and the physical pain of holding a hot cup of coffee [source: McMillan]. Breakups have also been linked to conditions like asthma, insomnia, flu, and shingles [source: Nelson].

While breakups don’t always lead to broken heart syndrome, extreme stress can strain the heart. Stress triggers the release of catecholamines, hormones from the adrenal glands that activate the "fight or flight" response. Doctors believe that an overload of epinephrine and norepinephrine (adrenaline and noradrenaline) can temporarily impair heart muscle cells, slowing its function and mimicking a heart attack [source: Winslow]. Once diagnosed, patients typically recover within a week, often with the help of mild medications like aspirin to improve blood flow [source: HealthDay]. However, researchers are still puzzled as to why women are more prone to this condition than men.

Are women's hearts more susceptible to breaking?

Broken heart syndrome is uncommon, impacting only 1 to 2 percent of patients undergoing cardiac catheterization, a diagnostic procedure for heart issues [source: Pope]. In 2007, 89 percent of the 6,230 reported cases of takotsubo cardiomyopathy in the U.S. involved women, with research from 2011 presented to the American Heart Association showing that women over 55 are 2.9 times more likely to develop the condition than younger women [source: HealthDay]. The reasons behind this gender disparity, whether due to heightened stress responses or postmenopausal hormonal changes, remain unclear.

The idea that women handle trauma or stress less effectively than men doesn’t hold up when examining the triggers of broken heart syndrome. The condition, often sensationalized in the media due to its evocative name, is more frequently linked to physical ailments such as stroke, respiratory failure, severe burns, and poisoning rather than emotional events [source: Derrick]. Johns Hopkins University research found that only 40 percent of cases were associated with emotional loss [source: Winslow].

Research on long-term couples passing away in quick succession also challenges the assumption that women are less resilient to loss. Statistically, widowers are more likely to die shortly after their wives, while widows often live longer [source: Martikainen and Valkonen].

Despite its dramatic name, broken heart syndrome is rarely fatal. While heart complications arise in about 19 percent of cases, the mortality rate is only 1 to 3 percent [source: Derrick]. As mentioned earlier, the enlarged left ventricle usually returns to normal size, as seen in Dorothy Lee’s case, and most patients recover fully within a week — much like the emotional healing of a metaphorical broken heart.