Broken Heart Syndrome - when a heart attack isn't a heart attack
It's been sung about many times, and "a broken heart" is a familiar image when you're heartbroken.
Few people know that this phenomenon really exists and is described in medicine as broken heart syndrome. Other terms used are stress cardiomyopathy or takotsubo cardiomyopathy. The latter name comes from the clay pots used by Asian fishermen to catch octopus. In takotsubo cardiomyopathy the left ventricle changes shape because the heart's apex contracts only weakly or hardly at all. The upper part narrows and there is a bulging toward the apex, which gives it a shape similar to those pots.
Broken heart syndrome causes the same symptoms as a heart attack. The complaints are identical. ECG changes typical of an infarct can appear, but they cannot be clearly assigned to a specific area of the heart. Blood tests also point toward a heart attack. In about 2 percent of patients with a suspected heart attack, doctors are surprised during the subsequent coronary angiogram (heart catheterization) because they do not find a blocked vessel that would explain a heart attack. On the heart ultrasound (echocardiogram), however, you can see a vase-shaped change of the left ventricle and an apex that hardly moves.
But broken heart syndrome should not be taken lightly, because it can also lead to serious, sometimes life-threatening complications such as severe heart rhythm disturbances or even cardiogenic shock.
What happens in broken heart syndrome?
In the vast majority of cases, broken heart syndrome is preceded by an emotionally stressful event. The death of a loved one, news of a serious illness, heartbreak, traumatic events like violence, natural disasters, or existential fear after losing a job. Positive events like marriage, winning the lottery, or similar surprises can also be triggers. In all these cases there is a massive release of stress hormones. Researchers suspect this as the origin of the disease. The overwhelming surge of stress hormones essentially overstimulates the heart wall. Specifically at the beta receptors, this massive attack by the usually heart-strengthening catecholamines seems to reverse their effect at least this was seen in animal studies on mice and rats. The heart muscle or the coronary vessels may go into spasm. This also explains the restricted movement of the apex: the apex has particularly many beta receptors. It is suspected that this is a protective mechanism of the body against dangerous overstimulation of the heart by the high concentration of stress hormones. Mainly postmenopausal women are affected, because the protective effect of estrogen on the heart decreases with lower estrogen levels. But men can also suffer from a broken heart.
For this reason drug treatment for broken heart syndrome is fundamentally different from that for a heart attack. While drugs that act on the adrenaline receptor are used for a heart attack, these would have no effect or, in the worst case, the opposite effect in broken heart syndrome a worsening of the condition, because the adrenaline receptor is the "damaged" part in this case. That's why drugs that do not act through adrenaline-like mechanisms are considered. In addition to medication, psychological support is important even almost more important. Patients need to learn coping strategies for stressful situations and work through the traumatic experience that led to the broken heart syndrome.
The heart heals completely in most cases of broken heart syndrome. After one to four weeks all changes in the myocardium have usually disappeared provided the patient survived the acute phase without complications.
So Udo Lindenberg is wrong when he sings: "You can't fix a heart."
You can fix a heart, but it needs medical help unfortunately a broken heart doesn't always heal completely on its own.
Sources:
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 01/2026).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
