Broken Heart Syndrome Symptoms Can Mimic a Heart Attack—What You Need to Know to Stay Safe
Experts say women are more at risk
Broken heart syndrome sounds like something out of a romance novel. But it’s a bona fide medical condition that feels like a full-blown heart attack—and research reveals it’s especially common in postmenopausal women. Here, experts shed light on the broken heart syndrome symptoms you shouldn’t ignore and how the condition is treated.
What is broken heart syndrome?
“Broken heart syndrome involves a weakening of the heart muscle, typically after an acute stressor,” notes Ahmad Takawol, MD, cardiologist and broken heart syndrome expert at Mass General Brigham. Also known as takotsubo syndrome or stress-induced cardiomyopathy, it usually occurs following an intense emotional event such as a romantic breakup or the death of a loved one.
But positive events like surprise parties and winning a casino jackpot are also documented triggers, as are physical stressors such as stroke and septic shock (a life-threatening blood infection).
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Though the mechanisms behind broken heart syndrome aren’t clearly understood, experts believe a sudden surge of adrenaline and other stress hormones is an underlying culprit. “In response to adrenaline and adrenaline-like compounds, microscopic blood vessels in the heart constrict,” explains Dr. Takawol.
And according to Adjoa Boateng Evans, MD, MPH, critical care anesthesiologist at Duke University School of Medicine, surging stress hormones can have direct toxic effects on the heart itself. The result: “The heart not only loses its strength, it changes its shape so that the tip of the heart actually bulges or balloons outward,” Dr. Takowol notes.
Who’s most at risk?
Not everyone who’s exposed to intense physical or emotional stress develops broken heart syndrome—and again, experts aren’t sure why. Some studies suggest broken heart syndrome has a genetic component, while others indicate depression and anxiety are risk factors.
Plus, drops in estrogen that occur due to menopause may leave women more vulnerable to the syndrome. In fact, a report in the journal Cureus estimates that 90 percent of cases occur in postmenopausal women.
“Most patients have a full recovery, and oftentimes pretty quickly.” —Mohanakrishnan Sathyamoorthy, MD, FACC
Broken heart syndrome symptoms to watch for
Broken heart syndrome isn’t a heart attack, since it’s not marked by blockages in coronary arteries. But its symptoms closely mimic those of a heart attack—and it can be impossible for patients to tell the difference.
“As a patient, you’re aware that something serious is going on,” says Mohanakrishnan Sathyamoorthy, MD, FACC, chair of internal Medicine at Burnett School of Medicine. “It feels like you’re in a death experience.” And since both conditions can have serious consequences, it’s crucial to call 911 and get immediate medical attention if you experience the following symptoms:
- Chest pain
- Shortness of breath
- Dizziness or fainting
- Heart palpitations
- Sweating
- Pale skin
- Nausea and/or vomiting
While the symptoms are the same, one clue that you might be experiencing broken heart syndrome instead of a heart attack is if you’ve recently suffered intense emotional or physical stress. But again, only a doctor can make that diagnosis, and you’ll still need urgent medical care.
How broken heart syndrome is diagnosed and treated
Because symptoms of broken heart syndrome are so hard to distinguish from those of a heart attack, proper diagnosis involves a series of medical tests. Some to expect:
- An EKG to assess the heart’s rhythms
- Blood tests that check for elevated cardiac enzymes
- Imaging such as echocardiogram to assess the function and shape of the heart and its chambers
- Cardiac catheterization or coronary angiography to identify blockages in coronary arteries
“When we find the combination of no blockages in the large blood vessels but abnormal heart function, that leads us to the diagnosis of broken heart syndrome,” Dr. Tawakol explains.
Treatment of the syndrome focuses on supporting the heart so it can rest and recover. “We often give drugs to quiet down the impact of adrenaline, such as beta-blockers,” he says. “And while the heart is not moving well, we’ll also give other medicines to improve the pressures around the heart—for example, ACE inhibitors.”
And though some people with broken heart syndrome may need a stay in the intensive care unit and additional treatment, Dr. Evans notes that patients usually recover within one to two weeks.
Can you die from broken heart syndrome?
“It’s possible, depending on how significant the shock to the heart is,” says Dr. Sathyamoorthy. Indeed, a 2025 study in the Journal of the American Heart Association found that broken heart syndrome was fatal in 6.5 percent of cases. Plus, major complications of the syndrome included congestive heart failure, atrial fibrillation, strokes and heart attacks.
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