Death by Broken Heart?

Death by Broken Heart?

Q: Can you die of a broken heart?

A: Yes and no. Sometimes people get news that’s so stressful it sends catecholamines coursing through their body. These so-called “fight-or-flight” hormones trigger a primitive, almost animal response that may simulate a heart attack. “Our emotional centers send a message to our adrenal glands to send those catecholamines coursing through our bodies, and that response can be very severe,” says Will Meurer, M.D., M.S. ’09, an emergency medicine physician at the University of Michigan Health System and an assistant professor in the UM departments of Emergency Medicine and Neurology. “There are also direct connections from the brain to the heart through the sympathetic nervous system, and these connections may also play a role.”

Scientists refer to this phenomenon as “broken-heart syndrome,” or stress-induced cardiomyopathy. Patients who experience the syndrome may suffer chest pain and even injury to the heart, but most of the time the heart rebounds, Meurer says, and there’s no lasting damage.

Occasionally, however, the acute stress can send the heart into a fatal rhythm. So one can indeed die of a broken heart.

Meurer, who specializes in the acute care of stroke patients, says he sees broken-heart syndrome most often in patients who’ve had a subarachnoid hemorrhage, or SAH—a somewhat rare and potentially devastating form of stroke. Roughly 20 percent of those who suffer an SAH die, and Meurer says scientists don’t fully understand “how much insults to the heart may contribute to those deaths.” But they do know that there are direct neurological connections between the brain and the heart, and that the injured brain sends potentially damaging signals to the heart through those connections.

Meurer and his colleagues are trying to learn why this process happens and what can be done to interrupt it. In separate but related studies, the researchers are working to understand how the heart processes the “fight or flight” hormone norepinephrine and whether a beta blocker called esmolol can prevent injury to the heart when it undergoes broken-heart syndrome. Meurer notes that he began developing the esmolol study in a grant-writing class at SPH, where he was a student in the executive master’s program in clinical research design and statistical analysis.