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Can a Broken Heart Cause a Broken Heart?

When Grief is More Than the Heart Can Bear


Most of us have heard occasional stories about elderly couples, after a happy marriage of many years, dying within hours or days of each other. Circumstances like this have long caused researchers to wonder if the term "broken heart" can be a physical as well as an emotional state.

A new study from the CardioVascular Institute (CVI) at Beth Israel Deaconess Medical Center, published in the American Heart Association's journal Circulation, has found that there's truth behind the concept of "broken heart" syndrome.

After studying 1,985 heart attack patients, CVI researchers discovered that the risk of a heart attack skyrockets for survivors after the loss of a loved one. In the first 24 hours after the death of a beloved person, heart attack risk rises to 21 times the norm. That rate remains eight times above normal during the first week after the death, before steadily declining over the course of a month.

The physiology behind this data is connected to the intense depression, anxiety and even anger that a person who is grieving may experience. These emotions can increase heart rate, blood pressure and even the chance for blood clots to form, which increases the chance of a heart attack.

"We were surprised with the strength of the study's results - it's quite rare to find a risk increase of this magnitude based on one factor," says senior study author Murray Mittleman, MD, DrPH, a CVI physician and Director of BIDMC's Cardiovascular Epidemiological Research Program.

Murray A. Mittleman, MD"We need to pay close attention to surviving family members after the death of someone close to them," says Mittleman. "It's very important for the grief-stricken to take care of themselves. If an individual develops symptoms that may mark the beginnings of heart attack, we really need to take it very seriously and make sure that that patient gets appropriate evaluation and care."

Mittleman also emphasized the importance of friends and family members checking in to ensure that surviving family members are taking their medications as prescribed.

"The results of the study may be attributed in part to a lack of medication in addition to experiencing grief," he adds.

The study is just one segment of a larger body of work conducted by Mittleman and BIDMC.

"We have long been examining the effect of physical and psychological stress on the risk of heart attack," he explains.

Physical risks can involve intense bursts of activity, like shoveling snow, for someone with a sedentary lifestyle. Additional psychological risks studied have included outbursts of anger or periods of intense anxiety that precipitate a heart attack.

Mittleman continues to seek a deeper knowledge of the "broken heart" syndrome.

"We are now collaborating with colleagues at the Karolinska Institute in Stockholm, Sweden, on a series of projects to take this research to the next step," he says. "We'll be expanding the scope of our research by using Sweden's national medical record system to evaluate millions of individuals over a longer period of time."

With this new research, Mittleman and his colleagues will now be investigating the grief impact of different relationships, such as the loss of a child versus a spouse. They will also examine the impact on people with different levels of cardiovascular risk and whether there's a difference between unexpected sudden death and death resulting from a chronic and often fatal illness.

These continuing investigations will strengthen the ability for grieving survivors, their families and their physicians to be alert and aware of heightened risk factors after a death occurs.

While stories about the consecutive deaths of a couple may sound like a sign of a lifelong romance, the truth is that one loss does not have to lead to another. Taking care of those who are left behind can help grieving hearts to survive one of life's toughest challenges and find happiness once again.

Above content provided by the CardioVascular Institute at Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted February 2012

Contact Information

CardioVascular Institute at
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215