Everyone knows that keeping stress levels low is an important component of a healthy lifestyle. Managing stress can have all sorts of positive effects on your health, like lowering blood pressure and cholesterol levels, which can lead to a decrease in risk of heart disease.

But have you ever wondered if stress itself can directly cause a heart attack? The answer is - not exactly. But sudden, severe stress can cause something called stress cardiomyopathy (also known as "broken heart syndrome" or "takotsubo cardiomyopathy"), an under-diagnosed health condition with symptoms that are very similar to those of a heart attack.

What is it?

The word cardiomyopathy refers to heart muscle that is weakened, resulting in the heart not working as well as it should. Stress cardiomyopathy refers to weakening of the heart as a result of intense physical or emotional stress.

The intense grief that comes with the death of a loved one is a common cause of this condition. However, emotions like extreme anger, fear, and surprise can also cause it. Physical stress to the body includes stroke, dehydration, or low blood sugar.

What happens?

After a person experiences an intense emotional event, stress hormones (such as adrenaline) are released into the body at levels that can be 10 to 30 times the normal levels. Stress hormones usually help the body cope with stress. However, at these toxic levels of hormones, it's thought that the heart becomes overwhelmed and "stunned" to the point where it can no longer pump properly.

It is not certain what exactly happens to result in the heart pumping inadequately. It may be due to a decreased oxygen supply to the heart or due to too much calcium entering the heart cells. In any case, it can result in shock, heart failure, and heart rhythm problems, all of which can be life-threatening if not treated.

But with treatment, most patients make a full recovery, sometimes in just a matter of weeks. The effects of excess stress hormones on the heart are brief and do not cause permanent damage to the heart.

What are the symptoms?

Symptoms of stress cardiomyopathy include sudden onset of chest pain, sweating, nausea, vomiting, shortness of breath, low blood pressure, and abnormal heart rhythms. These symptoms normally occur soon after a severely stressful event. Because many of these symptoms are also symptoms of a heart attack, it is easy to mistake stress cardiomyopathy for a heart attack.

Stress cardiomyopathy vs. heart attack
Heart attacks and stress cardiomyopathy can have very similar symptoms but they are different conditions. Most heart attacks are caused by blockages or blood clots in the coronary arteries (the blood vessels that supply the heart), resulting in a decreased flow of blood to the heart that can lead to heart muscle cells to die. This is what can cause permanent damage to the heart muscle cells.

On the other hand, the heart is not permanently damaged with stress cardiomyopathy. Stress cardiomyopathy does not seem to be a result of artery blockages or blood clots. For most people that suffer stress cardiomyopathy, the heart weakness usually stops within a couple of weeks and there is no permanent damage.

Lisa Tourountzas