On Father’s Day 2010, I gave my dad a card, and in response, he confessed something to me. He said that he hated Father’s Day because it made him miss his dad, who had died five years prior. He said that every year on Father’s Day, he’d go outside to cut the grass and cry to himself as he thought of his dad. I had no idea he’d been going through that type of grief.
Fast forward to Father’s Day 2011, when my dad died of a heart attack. I’ve never been able to shake the feeling that his heartbreak may have led to that. Of all days—that day. A day that reminded him of the pain he’d endured as a result of the end of his relationship with his dad.
The day after he died, there was a moment when my chest felt excruciatingly tight and I was short of breath. For several minutes, I thought I was having a heart attack. “No, I can’t be. I’m a healthy 21 year old,” I thought. It was terrifying. Eventually, the pain went away, and I disregarded that moment. But now, looking back, I think it’s possible that my heartbreak was having an impact on my actual heart.
Think of Allie and Noah in The Notebook. I’ll admit that when I first saw that movie, I thought the ending was way too dramatic and unrealistic. Now that I’m older and have experienced the loss of loved ones due to death and breakups, though, that ending doesn’t seem so far out there. To love someone and then no longer have them in your life is painful—and there’s some real science to back that up.
To learn more about the impact that emotional pain can have on our physical hearts, I spoke with Dr. Rachel M. Bond, a cardiologist and fellow with the American College of Cardiology who specializes in women’s heart health and prevention, and Dr. Nikki Stamp, a cardiothoracic surgeon and author of Can You Die of a Broken Heart?: A heart surgeon’s insight into what makes us tick. After speaking with both experts, it’s become clear to me that the ending of The Notebook was even more realistic than I’d imagined.
Broken heart syndrome is real
Broken heart syndrome is a real thing. Medical professionals refer to it as stress-induced cardiomyopathy or Takotsubo cardiomyopathy. “It’s a weakening of the left ventricle, the heart’s main pumping chamber, usually as the result of severe emotional or physical stress, such as a the sudden loss of a loved one or a serious accident,” explained Dr. Bond. “First described in Japan, it’s named after a Japanese octopus trap due to the shape of the trap being similar to the appearance of the left ventricle that balloons out.”
It’s not a heart attack
Although broken heart syndrome has symptoms similar to those of a heart attack, the two are not the same. “Classically, when we think of a heart attack, we think about atherosclerotic heart disease, meaning there is a plaque that builds up in the coronary artery and becomes unstable and ruptures, leading to a heart attack,” said Dr. Bond. “With Takotsubo, there is no such underlying cardiovascular condition. There is, however, a stressor that places a strain on the left ventricle, at times leading to the release of cardiac biomarkers or proteins that are also released when one has a heart attack.”
Broken heart syndrome is more prevalent in women than in men
“Over 90% of cases happen in postmenopausal women and the theory is that it has something to do with estrogen or the lack of it,” said Dr. Stamp. “It has absolutely nothing to do with your psychological resilience.”
As reported by the American Heart Association, this syndrome can be brought on by various emotionally stressful life events. “Virtually every case I’ve seen was after losing a loved one. Following the Christchurch earthquakes in 2011, there were over a dozen reported cases,” said Dr. Stamp. She also recalled a different type of heartbreak: “A colleague of mine once told me he saw a woman who was a prominent business leader who got Takotsubo cardiomyopathy after she lost the USB containing a very important presentation.” There’s also the 28-year-old woman Dr. Bond once treated, who had been studying for her LSATs when she had “acute onset of chest pain in the center of her chest.”
Don’t feel discouraged—if your heart breaks, you’ll probably recover
Dr. Stamp says that being broken-hearted is not a serious medical condition. “The vast majority of us feel rotten for a period of time (mentally and sometimes physically, too) but recover. It is incredibly uncommon to ‘die of a broken heart,’ but research in this area has been fascinating for showing a link between our emotions and our physical well-being.”
For people whose heartbreak leads them to the emergency room, such as Dr. Bond’s 28-year-old patient who had been studying for the LSATs, their condition can be treated. “Initially, the symptoms will be treated like those of a heart attack. Once a diagnosis is made, broken heart syndrome is treated with medicines, such as ACE inhibitors, to lower blood pressure, beta blockers to slow the heart rate, diuretics to decrease fluid build-up, and, sometimes, stress-reducing medications or activities,” she said.
Although there are no known ways to prevent broken heart syndrome, being proactive in maintaining a healthy lifestyle and finding ways to manage stress or trauma can support a healthy heart. “Any form of constant stress or extreme stress can take a toll on our body, particularly the heart. When you think about stress, our body naturally has a fight-or-flight response to alleviate it. However, when that response is constant and/or extreme, it can take a toll. This is why learning how to cope with stressful situations may be beneficial. One proven way, which has also indirectly been shown to improve cardiovascular health overall, is through meditation and its ability to lower blood pressure, cholesterol, etc.,” said Dr. Bond.
All told, it may seem scary to choose to love someone. Especially considering that losing them could literally break your heart. Still, when The Notebook ended, you aren’t left feeling sorry for Allie and Noah. You feel inspired by and maybe even envious of their love. Despite the ending, the journey seemed to be worth it, right? Keep loving—just take care of yourself.