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 symptoms identical to those of a heart attack. The symptoms are the same. The ECG changes typical of a heart attack occur. However, these cannot be clearly attributed to a specific area of the heart. Laboratory tests also indicate a heart attack. In around 2 percent of patients with a suspected heart attack, the doctors performing the subsequent cardiac catheterization encounter a surprise: they cannot find the blocked blood vessel characteristic of a heart attack. By contrast, an ultrasound scan of the heart shows a vase-shaped left ventricle and an apex of the heart that barely 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 something similar can also be triggers. In all these cases, there is a massive release of stress hormones. Researchers suspect that this is where the disease originates. 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 observed in research on mice and rats. The heart muscle or the coronary vessels may go into spasm. This also explains the restricted movement of the apex: there are particularly many beta receptors there. 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 as estrogen levels fall. But men can also suffer from a broken heart.
Therefore, drug treatment for broken heart syndrome differs fundamentally from that for a heart attack. While medications that act via the adrenaline receptor are used for a heart attack, in broken heart syndrome they would have no effect or, in the worst case, precisely the opposite effect-a deterioration in the patient's condition-because in this case the adrenaline receptor is the „damaged“ component. Therefore, active substances that do not act via adrenaline-like mechanisms are considered in this case. However, in addition to drug therapy, psychological support is also important-perhaps even more important. Patients need to learn strategies for coping with stressful situations and process the traumatic experience of broken heart syndrome.
In most cases of broken heart syndrome, the heart fully recovers. After one to four weeks, all changes in the myocardium have disappeared, provided the patient has 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 after all, but it needs medical help, because unfortunately a broken heart doesn't heal completely on its own.
Sources:
This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people 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 outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
