Heartfelt Emotions

More in Women than Men

Stress cardiomyopathy tends to strike postmenopausal women—the average age of patients is 60. Chest pain and shortness of breath are the main symptoms, and typically occur minutes to hours after an unexpected shock that causes grief, anger, or even surprise. (So think twice about throwing that big surprise party!) An attack also can occur following major medical procedures or other physical stressors, like stroke.

The good news about broken-heart syndrome is that if it’s properly diagnosed and treated, patients recover and experience no lasting health effects. Lee, for example, spent five days in the hospital and has since made a full recovery. Stress cardiomyopathy does not kill off any of the heart’s tissue, as a heart attack does. Therefore, Sharkey says, the “long-term prognosis seems to be quite good, quite different than the prognosis from a blocked artery, where longevity tends to be reduced.”

The not-so-good news is that researchers still have more questions than answers.

The Stress Connection

The theory that excess adrenaline causes stress cardiomyopathy is still just that, Sharkey says. A study reported by Johns Hopkins University researchers last year in the New England Journal of Medicine found that broken-heart syndrome victims had three to four times the amount of adrenaline in their blood that heart attack victims did, and up to 35 times that of healthy people.

Doctors also see adverse heart effects in some other patients from adrenaline—for instance, those who receive it as treatment for an allergic reaction, Sharkey says. What isn’t known yet is whether excess adrenaline causes arteries that serve the heart to narrow, or whether it binds to heart cells, disrupting their normal function, or has some other effect.

It’s no secret that anger or excitement causes our hearts to beat faster. But recent clinical studies have taken that “duh” observation about emotions and the heart further. Several studies, for example, have found a link between exposure to chronic noise and a mild to moderate increase in the risk of developing heart disease. (Women were most affected by noises such as traffic, and men by noisy work environments.)

Last October, a Finnish study found that men who perceived themselves as being treated fairly at work—being included in decision making, for instance—were 30 percent less likely to suffer chest pain, heart attack, or death from coronary artery disease than those who felt they were treated unfairly. Several studies have shown the staggering effects of depression on the heart; one study of postmenopausal women found that those who were depressed were 50 percent more likely to develop heart disease than those who weren’t. Another showed that heart disease patients who are depressed are 70 percent more likely to have a heart attack than those who are not. On the flip side, small studies have shown the positive effects of laughter and joy on blood flow and heart rhythms.

Sharkey says the frustrating thing about research on stress and the heart is that it’s tough to measure stress and figure out who’s most at risk for developing problems. “It’s a subjective feeling,” he says. “We don’t have a test that says, ‘Your stress level is 10 today’ to show a direct relationship between the magnitude of your stress and its effect on your organs.”