Science

Can You Die From a Broken Heart?

MYSTERIES

Doctors explain the very real medical effects of sadness and loss.

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Jordi Elias/Illustration Works, via Corbis

Hollywood glam and the dull realm of human physiology seldom align. Based on information provided by the big screen we would think, for example, that people could scale buildings and leap rooftops, sense impending doom with Swiss accuracy, and even fall in love without doubt, regret, or panic.

One area, however, where show biz accurately reflects cellular biomechanics is the broken heart. As Doug Flutie, former Heisman Trophy winner and star NFL player, learned after his parents died within an hour of each other, there is a well-recognized medical condition of death from a “broken heart.”

The connection between intensely stressful events and acute cardiac problems is an area of active research. In the medical world the term for broken heart, coined about 25 years ago, is takotsubo cardiomyopathy. The latter word “cardiomyopathy” is just a high-dollar way of describing a malfunctioning heart. It is the first word, “takotsubo,” that adds mystery.

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Takotsubo is Japanese for “octopus pot.” In Japan a pot rather than a net or fishhook or spear is used to capture an octopus. The octopus pot works like a Roach Motel but without the glue. The pot has a long narrow neck that the octopus slithers into and is trapped. The more he struggles the more trapped he becomes. He flexes his muscles but that only makes matters worse; the bigger he puffs himself up, the more impossible it is to escape. He is hoist by his own petard just in time to be tonight’s dinner.

Here’s the connection: The octopus pot, to certain cardiologists, looks exactly like a heart that is bulging strangely, as can occur after receiving bad news. For still uncertain reasons, even among people with normal coronary arteries and normal heart muscle, an acute emotional shock, like terrible news, can lead to a bulge at the tip of the heart. The bulge—sort of like grabbing a balloon and squeezing till the latex is so thin you worry about it popping—leads to inefficient blood pumping, which in turn can set off a calamitous chain of events, like severe heart failure, heart attack, and even death. Indeed, like the squeezed balloon, the heart muscle may thin so much that it can pop—called “rupture” in medical parlance.

Interestingly, most of the patients in whom the condition initially was described were elderly women, similar to Flutie’s mother. She was the second parent to die—the one whose heart may have been broken by the death of her spouse. More recent research however has demonstrated a wider reach to the condition, involving people of all shapes, sizes, and sexes.

In addition to wider and more accurate diagnosis, the impact of takotsubo may be felt more broadly these days because of a different, though equally predictable and inevitable phenomenon: the infantilization of adults globally. I am referring to the rising prevalence of the rabid sports fan. Studies have shown that, in addition to loss of a loved one, earthquakes, and nearby violence, medically broken hearts are frequent when a home team loses a sports event. The scientific literature has articles by the handful with titles like “A Missed Penalty Kick Triggered Coronary Death in the Husband and Broken Heart Syndrome in the Wife” and “A matter of life and death: population mortality and football [soccer] results.”

As the latter study demonstrates, there is a real and non-comic 28 percent increase in deaths (males only) the day of a home-team loss, with the increase attributed to cardiac events and strokes. In other words, takotsubo is more than an arcane medical problem, it is a public health problem, similar to the smaller though real problem of post-coital sex. We are not built, as it turns out, for too much excitement.

So as attention continues to be focused on the impact of sports on those playing, including important work defining post-concussion syndromes, reducing various orthopedic hazards and all the rest, the time may be upon us when the impact of sports on the viewer also needs to be studied. Though risible at first glance, it may be that living and dying for the old home team is more than words from a fight song.

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