Why can emotional pain lead to physical pain centered in the heart

Traumatic emotional stressor can be enough to cause physical damage to the heart, a syndrome known variously as takotsubo cardiomyopathy, stress-induced cardiomyopathy, or “broken heart syndrome.”

The syndrome was first noticed in Japan in 1990, where physicians discovered that people were presenting with the symptoms of a heart attack during initial testing. However, follow-up cardiac angiograms that look for the signature blood clots of a heart attack turned up clean.

Cardiomyopathy means a weakening of the heart muscle, of the heart’s pump.  Takotsubo is the Japanese term for a kind of pot specially designed to catch octopuses, of all things. When the Japanese researchers who first identified the syndrome examined the hearts of early patients, they saw the same type of appearance as the takotsubo bowl. The apex or tip of the heart balloons out, and the base of the heart contracts normally.

The condition got the nickname “broken heart syndrome,” however, when researchers began to notice that often an emotional or mental stressor, such as a loss of a loved one or a divorce, had preceded the symptoms.

The most common presenting symptoms are chest pain and shortness of breath, and patients with these symptoms must consider this an emergency and seek immediate medical attention for it may well be an acute heart attack. Patients also usually have an abnormal electrocardiogram, an abnormal echocardiogram and an elevated biomarker in their blood. Altogether, individuals with the syndrome present very much like they’re having a heart attack.

Only a cardiac angiogram will rule out an actual heart attack.

Even more fascinating is that these patients have completely clean coronaries and their heart pumps resolve in anywhere from eight hours to two months