Broken Heart Syndrome: When Stress Literally Stuns the Heart

Understand how severe emotional or physical stress—especially sudden loss—can trigger Takotsubo syndrome, a condition that mimics a heart attack but occurs even when coronary arteries are clear.
Discover why more than 90% of reported cases affect women ages 58–75 and how up to 5% of women diagnosed with heart attacks may actually be experiencing broken heart syndrome.
Learn how stress hormones like cortisol, epinephrine, and norepinephrine can “stun” the heart—and how acupressure points such as Heart 7 and Pericardium 6 may help regulate stress and calm the heart during crisis.

About the Expert

John Nieters, LAc, DAOM, CFMP

Dr John Nieters

Dr John Nieters has been teaching and practicing the combination of Functional Medicine paired with Traditional Chinese Medicine for several decades. He has been practicing Tai Qi, Qi Gong and meditation for 50 years.

He has hosted over 500 call-in talk radio shows on "The Balancing Point." He currently lives in Alameda, CA with his wife, Jenny and son, Johnny. His wife, Jenny, is the acupuncturist for the 49ers football and St Mary's Rugby team.

He has authored the book "The Sweet Spot," on how to read your blood work and plans to have two additional books published this year.

Dr John's patients, staff and listeners call me the "Story-teller".

And after the commercial, the doctor came on and this doctor had taken a chest X-ray, including the heart of one of his female patients. A couple of weeks later, the woman's husband died suddenly.

She started having heart attack symptoms, went back to see the doctor. He did another X-ray and saw that the entire shape of her heart had changed. Hi, and welcome to The Balancing Point.

I'm Dr. John Needers, and I'm here to make traditional Chinese medicine, functional medicine, and integrative health simple, practical, and fun, so you can restore balance, boost vitality, and enjoy a healthier life every single day.

Hi, this is Dr. John back with another in our series of different health conditions. This one's very fascinating to me, and you'll see why I think as I go through it.

So this condition actually has three names, and I'm gonna go through with you a little bit about why it has three names. But the bottom line is it has been traditionally called broken heart syndrome.

Now this has been known by some doctors for quite a while, but there wasn't any definitive proof until relatively recently. My old office manager, by old, I mean prior, was a nurse and was my office manager.

And she called me one day, all excited. She said, John, John, you've got to turn on Oprah. And I said, what? I don't watch Oprah. She said, turn on Oprah.

So I did. And after the commercial, the doctor came on and this doctor had taken a chest X-ray, including the heart of one of his female patients. Couple weeks later, the woman's husband died suddenly.

She started having heart attack symptoms, went back to see the doctor. He did another x-ray and saw that the entire shape of her heart had changed. So that he then was confirming that there was something called broken heart syndrome.

And then it's also known as stress cardiomyopathy or Takotsubo syndrome. And it can strike even if you're healthy. It often occurs when a person experiences severe emotional or physical stress.

Now the Takotsubo part is quite fascinating to me when I looked into it. It seems that in 1990 in Japan, some doctors noticed that this condition caused the left ventricle, which is the primary pumping chamber of your heart.

It's the last chamber that pumps the blood up through your aorta and out through your circulation. Well, they noticed that that chamber got enlarged. And they also noticed that it took the shape of a pot used by Japanese fishermen to trap octopuses.

So it's very big at the bottom and very narrow at the top. So the octopus can get in, but they can't get out. And this is very significant because the same thing happens in your heart.

The chamber starts to enlarge, you get more blood in it, but the, you get a narrowing at the neck so that you can't get as much blood out. So Takatsuba was kind of a cool name for it.

The broken heart syndrome is really stress-induced cardiomyopathy in terms of medical terms. And the important thing, it can strike even if you're healthy.

You can do everything right and still have a major stressor and have a misshapen heart. And again in Takatsubo it causes the heart's main pumping chamber to change shape and it gets larger.

And so what that means then when it enlarges is it weakens the heart muscle and it doesn't pump blood as well as it should. This can happen at any age, but it typically affects more women than men.

And one thing that's very significant is that unlike other cardiomyopathies, it is not an inherited heart condition. Cardiomyopathies, cardio means heart, myo means muscle, pathy means some condition or illness.

So cardiomyopathies, most of which are inherited, at least partially. And this is not related to that. So we know that this can come on suddenly, condition usually the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, serious accident, or even a natural disaster like an earthquake.

That's why it's also called stress-induced cardiomyopathy or broken heart syndrome. Most of the cases that I have seen and I believe all of them came after the loss of a loved one suddenly.

It certainly can happen for many of these other conditions, but that's the number one. Now, one of the things about this is it can often be confused with a heart attack.

So classic heart attack symptoms, severe pressure, the old elephant sitting on my chest and actually in my patients who have had heart attacks before seeing me.

That's what they said. It was like an elephant sitting on their chest. So very heavy, a lot of pain. And this usually arises from a blockage of the coronary artery, which brings a blood flow to the heart.

And the heart being a muscle must have constant, constant blood flow. Now the difference between that and Takotsubo cardiomyopathy. Now what's similar is they can both happen suddenly.

But the Takotsubo syndrome can happen even when the coronary arteries are completely clear. This does not have anything to do directly with the coronary arteries.

And so, again, the heart temporarily enlarges, doesn't pump well, while the rest of your heart functions normally, or it can even have more forceful contractions happening, which make it worse.

Now with Takotsubo syndrome, people will often experience less dramatic chest pain. They may have shortness of breath, sudden onset of fatigue, and usually it's pretty marked fatigue, cold sweats, or lightheadedness.

Now this is very, very important. If you have any of those symptoms, particularly after a stressful event, could be a visit from the IRS, it could be the death of a loved one, but any stressful event, you should take it very seriously, and particularly if you're female.

Who gets broken heart syndrome? More than 90% of reported cases are in women ages 58 to 75. In my practice, that is absolutely what I've seen. Research suggests that up to 5%, that's a lot, of women suspected of having a heart attack actually are having broken heart syndrome.

Now, it is possible to recover with no long-term heart damage, but that isn't always the case, so we like to be extra, extra careful with that. And again, this happens when we have a high amount of stress.

And with stress, we're releasing stress hormones, obviously. And we're all familiar with cortisol, which activates your blood sugar. gives you that feeling of being wired and perhaps invincible but then also epinephrine which makes your heart pump faster and stronger and norepinephrine that takes the blood out of the center of your body puts it in your hands and your brain so you're better able to deal with the stressor that's out there.

However, Again, it's well documented that when we have high levels of these stress hormones, even for a relatively short period of time, it's a problem.

And they essentially stun the heart. It's just hammering at the heart. And in some cases, the heart gets overwhelmed. It gets damaged by the sudden and rapid stress.

The heart muscle then weakens, causing complications, and those complications can include many things. It can include arrhythmias, shortness of breath, pain, et cetera.

Now, what that will feel like is the outpouring of adrenaline can lead to symptoms that feel like a heart attack. The heart's racing. The heart's pounding.

The heart rhythm can be disrupted. You can start having palpitations or missed heartbeat because the muscles weaken and the small arteries get narrow, which happens from those stress hormones.

It causes the arteries to get narrow to raise your blood pressure so that you can run away from the tiger. At any rate, all of this can make you feel short of breath, have chest pain or chest heaviness, rapid irregular heartbeat, or severe fatigue and dizziness.

So many conditions can cause this, but the bottom line is any heavy financial loss. And again, I mentioned the IRS, which many people have very high stress reactions to an IRS visit.

Severe pain can cause it, a sudden drop in blood pressure, a medical procedure, domestic violence. That's a biggie actually. Receiving bad news, car accident, But the biggie is an unexpected loss, illness, or injury of a close relative, friend, or pet.

But one thing that can trigger it that's often overlooked is a fierce argument. The effects of a fierce argument can literally elevate your stress hormone for several days.

Now on the list of things good that can happen, someone giving you a surprise party where, you know, people jump out and it shocks the heck out of you.

So even some good things can cause this. Again, I want to talk a little bit about the difference between broken heart syndrome and a heart attack. Now, the symptoms can be indistinguishable from those of a heart attack.

So you need to have an electrocardiogram done. And some items on the electrocardiogram can look the same, like in what's called the ST segment elevation.

But someone good, a cardiologist for example, reading your electrocardiogram can definitely, definitely tell the difference. And they will then schedule for you for additional testing.

So again, the EKG, you can have blood tests to see if there's actual damage to the muscle of the heart, such as what would happen with blocked blood flow.

And so that could be a troponin test or a BNP that will tell you if there's actual damage to the heart muscle. They'll do tests to see if there's signs of blockages in the coronary arteries.

Test to show ballooning and an unusual movement of the lower left heart chamber or the ventricle. Now the overall shape can be an X-ray. They might have to do an ultrasound of some type to see the movement of the heart.

Now, recovery time traditionally is about six weeks. However, I've seen people that didn't really recover from this, particularly if they had any heart issues beforehand.

And so we take this very, very seriously. If one of our patients has a loved one who passes away, we immediately get them in here and do a minimum of one treatment a week for six weeks, because we wanna get that heart back into shape as soon as possible.

Now, heart in traditional Chinese medicine is the character xin, which actually means heart-mind. In Chinese medicine, those really aren't, I'm going to say, separated.

They're distinguished, but not separate. And so the earliest book that's still existing of traditional Chinese medicine, the Huang Dini Jing or the yellow emperor's classic, some people date at 2600 BC.

I think it's more recent than that. Probably around 200 BC, but whenever it was written, it's got some amazing information in it. And so when we're looking at the things that can be quoted from the wangdi, one is the heart governs blood, the heart controls the blood vessels.

Well, modern medicine and traditional Chinese medicine are certainly going to agree on those two functions of the heart. The cardiovascular system makes up the heart, the blood vessels, and the blood itself.

So another quote from the Huangdian aging, the heart houses the shen. Now this one is a little harder to capture it with the Western mind. I mentioned that shen translates as heart mind and the shen roughly translates as the mind or spirit.

So it's what perceives ourselves, it's what perceives the world. Our mental and emotional state depends on the shen. It's our ability to think, recall memories, et cetera.

Now, my mom used to say that the eyes are the window to the soul. And in Chinese medicine, often the eyes are the windows to the shen because we're really talking about the same thing.

So one more thing to consider is what's the connection to the heart? many functions of the shin correlate to the functions of the brain. The brain receives stimuli from our senses and decides what's important for us to notice, controls emotions.

And so when we're seeing something as extreme as takotsubo cardiomyopathy, it's recognized as a stressed induced condition, which causes a ballooning of the important left ventricle.

Now, some things to note, It's well known that heart disease has a negative impact on cognition. This is most likely explained in Western medicine by the consequences of reduced oxygen levels in the blood.

We know that coronary heart disease comes with a 45% increased risk of dementia or cognitive impairment and could accelerate cognitive decline by 66%.

So this is really, really huge. There's also a positive correlation between mental health disorders and coronary heart disease. the dysfunction and dysregulation of the autonomic nervous system.

So we know the sympathetic nervous system, which activates our kind of waking activities. But then there's the autonomic nervous system, which controls all of our bodily functions, essentially.

We don't have to tell the heart to beat. The autonomic nervous system tells the heart to beat. We don't have to tell our intestines to digest the food.

The autonomic nervous system does that. And the HPA axis, the hypothalamic-pituitary-adrenal axis, is very important in many mental health disorders. And the hypothalamus and pituitary are both located in the brain and control much of adrenal function.

If there's a problem with the HPA axis, we get various heart rate irregularities, inflammation, and increased platelets. And platelets, when they're increased, can have an increased blood clotting problem.

Now, I want to give you a couple takeaways here. other than just if you have any of these problems after a stressful event, get to see your doctor, go to the ER, urgent care, etc.

But I want to give you a little takeaway and I'm going to talk about three acupuncture points that you can do with acupressure, right? Just pressing on them, rubbing them.

And one of those is called heart eight. In the United States and in most non- oriental countries, Southeast Asian countries, we number the points. In China and Japan, they use the names of the points, which actually tell you what the function is.

And so Hard Eight or Shaofu, It's located on the palm between the fourth and fifth, that's your ring finger and little finger, metacarpal bones. Those are the bones at the end of your hand.

So when you make a fist, the points where the tip of the little finger touches. And that functions to clear heat and inflammation from the heart. Very powerful for clearing heat.

probably the most powerful heart point, at least the one that I use the most often is heart seven or shenmen. And again, shenmen, shen, spirit, men, gate.

And so it's located on the wrist just above the pinky finger, right above the wrist crease. You'll find a bone there. And if you feel a little bit more deeply, you can feel some pulse taking place there.

I would say look this one up on the internet and you'll find hundreds of articles about this. This one is really, really powerful to slow things down pretty quickly.

Stress, anxiety, panic, somnia, motion sickness. I was going to my brother's wedding and I had my mom in the car and my sister was following us in a car and she suddenly called us and said she had horrible car sickness.

So we pulled over, I ran back and I pressed on heart seven for a while and she was able to make the rest of the drive. So it's a very powerful point. I use it a lot for memory loss, forgetfulness.

palpitations, but most of my dementia patients will have this point treated. And the last point I'm going to mention is pericardium 6 or Neguon. And this one's pretty easy to find if you know what you're looking for.

If you make a fist, you'll see two tendons that pop. on your forearm. Well, this is between those two tendons and it's about two of your thumb widths away from the wrist crease.

And if you press deeply, you'll be able to feel the point. And this is used to reduce anxiety, stress, irritability, and a major point to regulate what we call the fire element to make sure that the physical and emotion bodies are in tune and regulated.

So Coming to the end here, the bottom line of all this, it's important to take care of yourself during stressful situations. It's obviously important to take care of yourself during all situations, but under stress, do not underestimate the danger that can occur.

Now acupuncture and herbs are a great way I mean, a great way to help calm the mind and heart during these times. So if you're having trouble dealing with stress, schedule an acupuncture appointment today.

We do a phenomenal job of treating this. So I want to thank you for tuning in, either listening or watching my slide presentation. And I want you to be happy, be healthy.

Goodbye. This is Dr. John. Thank you for joining me on The Balancing Point. If you enjoyed today's episode, please follow the show, share it with a friend, and leave a review.

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Broken Heart Syndrome: When Stress Literally Stuns the Heart

About the Expert

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Interested in knowing if we are the right fit for you and your condition?

Alameda Acupuncture

Ancient medicine for our modern world

Broken Heart Syndrome: When Stress Literally Stuns the Heart

About the Expert

Recent Posts

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Interested in knowing if we are the right fit for you and your condition?