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“Stress can trigger a typical heart attack and people die from that,” says Dr Harmony Reynolds, the director of the Sarah Ross Soter Centre for Women’s Cardiovascular Research at New York University Langone in New York state.

A common example of “dying from a broken heart” is someone who dies soon after losing a partner.

“Some of that is heart disease, I don’t think we fully understand exactly why that is,” Reynolds says. “It’s just one of the many bits of evidence that stress is a trigger of cardiovascular disease.”

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What is broken heart syndrome?

Takotsubo syndrome is a “temporary heart condition often brought on by a mentally or physically stressful event such as the death of a loved one”, according to Reynolds’ clinic.

It makes up about 1 per cent of all acute coronary syndromes and can often feel indistinguishable from a heart attack – making quick medical intervention imperative.

This sudden weakening of the heart’s left ventricle likely occurs because the autonomic nervous system is out of balance, Reynolds says. The cause may be physical or emotional stress, but she sees cases with an unidentifiable stressor about a third of the time.

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Symptoms of Takotsubo syndrome don’t have to go into effect the moment the “heart breaks”, so to speak.

“Just as often I’ve seen in my clinical practice, it doesn’t happen immediately, it might happen days or weeks later,” Reynolds says. “One of the phenomena with stress is that we ruminate about it, and sometimes those thoughts are even subconscious.”

It’s also sometimes set off by “happy stressors” – positive life events like celebrations, particularly emotional speeches or the birth of a grandchild, Reynolds says.

In Takotsubo syndrome, 90 per cent of affected patients are postmenopausal women, many of whom have previously been diagnosed with mood disorders or brain diseases, including strokes.

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“The postmenopausal timing for so many of the women makes it clear to us that hormones are in some way involved,” Reynolds says. “But it’s not at the moment of menopause, so it doesn’t seem to be the withdrawal of the hormones themselves.”

Treatment is still relatively unknown, though Reynolds has seen angiotensin-converting enzyme (ace) inhibitors, drugs prescribed to relax blood vessels and lower blood pressure, make a positive impact on recovery.

NYU Langone’s clinical trials are attempting intervention through exercise, yoga and meditation, known to aid in relaxation through deep breathing.

What to do if you’re experiencing broken heart syndrome?

It’s safer to assume it’s a heart attack and head to the emergency room immediately.

Takotsubo syndrome may not occur as pain in the chest, it could be anywhere between the jawline and teeth to the upper stomach, Reynolds says. It may also include shortness of breath, nausea, vomiting, sweating or a “sense that something feels wrong”.

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Reynolds’ research on heart disease in women leads her to offer this advice for women potentially experiencing Takotsobu syndrome:

• Don’t diminish your pain: “I’ve tried to use the name (broken heart syndrome) less because some of the people who’ve had it find it minimises what happened to them,” Reynolds says. “People think, ‘They could’ve been in control of it, if they just weren’t so upset these women would’ve never had this problem’.”

• Go to the accident and emergency department immediately: don’t assume it’s not a heart attack.

• Advocate for yourself: “Walk in and say, ‘I think I’m having a heart attack,’” Reynolds says. A 2022 study in the US found women with chest pain experience longer waiting times in the emergency room than men and women of colour wait even longer.