Is it possible to die of a broken heart?

It’s the stuff of legends, poems, and country music lyrics. Ever since the ancient Egyptians attributed personality and emotion to the throbbing organ within the breast, the idea of dying of a broken heart has permeated our cultural consciousness. Of course, we’ve known since the Enlightenment that the heart doesn’t actually house the soul, and in the last century, the dawn of modern medical science promised to finally dispel those silly death-by-sorrow superstitions once and for all. But when researchers finally applied the scientific method to the study of heartbreak, they got some surprising results.

In 1969, a landmark study appeared in the British Medical Journal. Researchers followed 4,500 widows for 9 years after their husbands died, and found that they had a 40 percent greater chance of dying in the six months following their husband’s death. After that, the risk gradually returned to normal. And what did most of these grieving widows die of? A heart attack, of course.

Every subsequent study of a person’s risk of dying following a loved one’s death has found a similarly marked increase in their risk for a heart attack. But recent studies have shown that a much stronger effect can be seen in the risk of dying from an accident, violence, or alcohol-related problems. For this reason, most doctors suspect that it’s a change in behavior caused by grief that leads to death after heartbreak—a psychological rather than physiological phenomenon. And interestingly, this increased risk of death following the loss of a loved one is much greater for men than for the supposedly more emotional sex.

But women have their own unique worry in the face of heartbreak, according to studies published this February. Doctors at Johns Hopkins University were intrigued by patients who showed up at the emergency room following an emotional shock, like the death of a loved one or a car accident. These patients, mostly women, had classic heart attack symptoms, like chest pain and shortness of breath. But their electrocardiograms looked very different from regular heart attack EKGs, and subsequent tests showed that the heart tissue was not damaged at all. A classic heart attack (myocardial infarction) occurs when an area of the heart muscle dies. So the doctors realized that this new, rare heart condition, which they dubbed “acute stress cardiomyopathy,” must be an entirely different phenomenon.

The researchers at Johns Hopkins examined 19 patients who presented symptoms of Broken Heart Syndrome, as acute stress cardiomyopathy came to be called, between 1999-2003. Most were women, and most were in their 60s and 70s (but one was 27). None had a history of heart problems or chronic stress, and all had just received unexpected bad news or experienced a sudden surprise (including one surprise birthday party). These patients had many times the normal amount of stress hormones in their blood, and the researchers determined that these hormones, including adrenaline, were impairing the heart’s ability to pump. Luckily, all the patients recovered with little more than bed rest and fluids, and none suffered long-term damage. But if a person with a previous heart condition experiences Broken Heart Syndrome, they may not be so lucky.

So, it appears that it is possible to die of a broken heart. Of course, stress hormones and psychologically-induced risky behavior are much less romantic than the notion of sorrow alone taking a person’s life. But consider all those ancient legends and myths (see image above) that feature death by heartbreak—does knowing that they could be explained physiologically make them any less beautiful? That, my anonymous friend, is a question scienceline cannot answer.

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