Broken heart syndrome, also known as stress-induced cardiomyopathy or Takotsubo syndrome, is a medical condition that can occur in response to intense emotional or physical stress. It is a temporary and reversible heart condition that can cause chest pain, shortness of breath, and other symptoms that resemble a heart attack. Unlike a heart attack, however, broken heart syndrome does not involve blockages in the heart arteries. Instead, it is thought to be caused by a surge of stress hormones that temporarily disrupt the normal functioning of the heart muscle. Most people with broken heart syndrome recover fully within a few weeks to months, but in rare cases, it can be life-threatening. Treatment may involve medications to manage symptoms and support the heart, as well as addressing the underlying emotional or physical stress.

The exact cause of broken heart syndrome is unclear. It's thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn't completely clear.

A temporary squeezing (constriction) of the large or small arteries of the heart may play a role. People who have broken heart syndrome may also have a change in the structure of the heart muscle.

Broken heart syndrome is often preceded by an intense physical or emotional event. For example, an acute illness (such as an asthma attack or COVID-19 infection), major surgery or a broken bone can lead to broken heart syndrome. Anything that causes a strong emotional response, such as a death or other loss, or a strong argument may trigger this condition.

Rarely, use of certain drugs may lead to broken heart syndrome, including:

• Emergency medications used to treat severe allergic reactions or severe asthma attacks
• Some medications used to treat anxiety
• Nasal decongestants
• Illegal stimulant drugs, such as methamphetamine and cocaine

Always tell your health care provider about the medications you take, including those bought without a prescription. When starting a new medication, talk to your provider about the potential risks and side effects.

To prevent another episode of broken heart syndrome, many health care providers recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart.

Some people who have chronic stress may have an increased risk for broken heart syndrome. Taking steps to manage emotional stress can improve heart health and may help prevent broken heart syndrome.

There's no standard treatment for broken heart syndrome. Treatment is similar to heart attack treatment until the diagnosis is clear. Most people stay in the hospital while they recover.

Many people with broken heart syndrome fully recover within a month or so. You'll likely need to have another echocardiogram around 4 to 6 weeks after you first had symptoms to be sure your heart has recovered.

Medications

Once it's clear that broken heart syndrome is the cause of the symptoms, medications may be prescribed to reduce the strain on the heart and prevent further attacks. Medications may include:

• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers (ARBs)
• Beta blockers
• Diuretics
• Blood thinners if there is a blood clot

Surgeries or other procedures

Surgeries and procedures that are often used to treat a heart attack — such as balloon angioplasty and stent placement or open-heart surgery — aren't helpful in treating broken heart syndrome. These procedures treat blocked arteries, which are not the cause of broken heart syndrome.