Dying of a broken heart: Yes you can, and mass shootings, COVID, stress increase risk

·5 min read

Can you suffer from – and die of – a broken heart?

A growing body of medical research suggests you can – and the likelihood has increased during the COVID-19 pandemic.

After Thursday's death of Joe Garcia, whose wife, Irma Garcia, was one of two teachers killed in the mass shooting at Robb Elementary School in Uvalde, Texas, family members said his heart was broken.

"I truly believe Joe died of a broken heart, and losing the love of his life of more than 25 years was too much to bear," wrote Debra Austin, a cousin of Irma Garcia, on a GoFundMe page to raise money for the Garcias' surviving four children. So far, the page has raised more than $2.5 million.

Perhaps that's because many Americans can empathize. Even before COVID-19's arrival in early 2020 led to a national shutdown, a medical condition called Takotsubo cardiomyopathy, also known as broken heart syndrome, was on the rise.

What is broken heart syndrome?

In cases of broken heart syndrome, the heart's main pumping chamber temporarily enlarges and pumps poorly, according to the American Heart Association. As a result, patients experience chest pain and shortness of breath, symptoms that can resemble a heart attack.

"The heart muscle suddenly becomes weakened in the setting of severe stress," said Dr. Ilan Wittstein, a cardiologist and professor at Johns Hopkins University School of Medicine. He co-wrote a study of the syndrome in 2005.

Stress that leads to broken heart syndrome can be emotional – death of a loved one, or fear after a car accident or being the victim of a crime – or it can be physical, such as a stroke, pneumonia or a severe infection, or even extreme physical exercise. "If you think about the heart as a pump that has to pump blood to the rest of the body, if the heart muscle suddenly weakens, it can create a situation where blood isn't getting to the vital organs, and a person can die," Wittstein said.

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Broken heart syndrome differs from a traditional heart attack because patients typically do not have blockages in arteries of the heart, he said. Unless there's an autopsy, it's impossible to know whether the person died of a heart attack, broken heart syndrome or another type of trauma or stress-induced heart ailment, Wittstein said.

"It's those chemicals, hormones and proteins that are produced in the body during stressful times that can really be the instigator of all three of those conditions," he said.

As for Garcia, "there's no question that what he was going through contributed to" his death, Wittstein said.

The rates of broken heart syndrome have increased in recent years, according to a study from Dr. Susan Cheng, a cardiologist and epidemiologist and director of the Institute for Research on Healthy Aging in the department of cardiology at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles.

The study, published in October 2021 in the Journal of the American Heart Association, found an increase in rates of broken heart syndrome from 2006 to 2017. More than 135,460 Americans had the syndrome during that time, and women ages 50 to 74 had the highest increase.

Even though women are more likely to have broken heart syndrome, research has found that "when men get this, they actually are at higher risk of dying from it," said Wittstein, who wrote an editorial on the research in the May 31 issue of the Journal of the American College of Cardiology.

"If this was broken heart syndrome that actually was the cause of death (for Garcia), it's certainly more common to see someone die of it when they're male than when they're female," Wittstein said.

How has COVID affected broken heart syndrome?

Cheng's ongoing research suggests broken heart syndrome, stress-related heart disease and traditional heart attacks have risen during the pandemic.

"We're seeing it exacerbated," Cheng said.

More patients with only a few or no heart risk factors – smoking, diabetes, high blood pressure, high cholesterol and sedentary living – are having heart events, too, and stress from the pandemic is among the culprits, she said.

"Where before you needed only a little bit of stress on top of a lot of preexisting risk factors to trigger a heart attack, now you don't even need that much in terms of preexisting risks … because there's so much stress," Cheng said. "We have a new baseline of stress that we're all living with now. And when you pile on top an incredibly profoundly tragic event as what took place in Texas at the Robb Elementary School, that just completely overwhelms the system."

Respiratory problems brought on by a COVID-19 infection probably could increase cases of broken heart syndrome, too, Wittstein said. "I think the pandemic has sort of led to this spike in cases from different angles, both the emotional side and the physical side."

What can I do to lessen the risk of broken heart syndrome?

If a person survives the onset of broken heart syndrome, they can often recover within days or weeks, the AHA says. But the long-term effects of the syndrome remain unknown and are being studied. Some research has suggested people who have had broken heart syndrome have a higher risk for future heart events.

We live under such a stressful environment, Cheng said, that she encourages people to "see if you can take steps toward unpacking that stress."

Some may want grief counseling, which can be provided by employers or community organizations, or therapy. Activities such as yoga, tai chi, other exercise and meditation can help relieve stress.

"We don't have a medicinal cure for stress," Cheng said. "But we can try to recognize the loss and how that impacts us as individuals living in those communities, and even remotely. I can tell you, personally, when that story unfolded, I think every single parent I know, regardless of where they lived in the world, was profoundly impacted."

Amid today's "incredibly high environmental stress," she said, "to recognize how that's impacting us as individuals, as well as our social and our family and household connections, is key."

Follow Mike Snider on Twitter: @mikesnider.

This article originally appeared on USA TODAY: Broken heart syndrome: Joe Garcia's death in Uvalde captures attention

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