Yes, a broken heart is real and can be fatal

MANILA, Philippines—“‘Till death do us part” is what couples say to each other when they exchange vows on their wedding day to stress a strong commitment to the marriage which everyone, especially couples themselves, expect to last.

Indeed, with love binding most couples who spend years together until one of them dies, the vow already made its way to millions of weddings as a great reminder to newlywed couples that death should be the only reason for their separation.

But in some instances, not even death can get in the way of couples already made strong by years of sincere love and care for each other. As they say, “not even death can separate us.”

This was exactly what happened to Rodrigo Sr. and Paulina Benedicto, who died three days apart in 2021—Paulina on July 28 while Rodrigo Sr. on July 31.

“No one was expecting it,” their grandson, Jose Benedicto Jr., told INQUIRER.net, expressing belief that Rodrigo Sr., was unable to bear the sorrow of losing Paulina, his wife of 60 years.

Rodrigo and Paulina were 79 and 80 years old when they died less than a year after celebrating their diamond wedding anniversary with people closest to them.

“What they did was not only ‘till death do us part, but ‘till death and beyond,” Jose Jr. said of his grandparents, adding that their “endless love for each other” had consoled him and the entire family in their time of grief.

As Jose stressed, no one in the family expected that while they were grieving over Paulina’s death, another tragedy would strike three days later, especially since couples dying at the same time or in the same week is unusual.

But the medical website WebMD said there is something called “broken heart syndrome,” which could be the reason that, in some instances, couples married for decades die within a few days of each other.

“Losing a loved one can be emotionally devastating. It’s rare, but sometimes an overwhelming loss can affect physical health, including the heart, too,” it said.

Heart responds to sadness

According to Mayo Clinic, a US-based academic medical center, broken heart syndrome is a heart condition that’s often brought on by stressful situations and extreme emotions.

READ: Do you have the ‘broken heart syndrome’?

It said the exact reason for the syndrome is not yet clear, but it is thought that a surge of stress hormones, like adrenaline, might cause damage to the hearts of some people.

“A temporary squeezing of the large or small arteries of the heart may play a role. People who have broken heart syndrome also may have a change in the structure of the heart muscle,” Mayo Clinic said.

An intense physical or emotional event often comes before broken heart syndrome. Anything that causes a strong emotional response, like the death of a loved one, may trigger the condition.

Mayo Clinic said on its website that reasons for the condition also include sudden illness like an asthma attack or COVID-19 infection, major surgery, sudden broken bone, and strong argument.

Johns Hopkins Medicine explained that two kinds of stress — emotional or physical — often cause the condition. But while most people with this condition experience a stressful event, some 30 percent have no identifiable trigger.

Emotional stressors, it said, include grief, fear, extreme anger, and surprise, while physical stressors include high fever, stroke, seizure, difficulty breathing such as an asthma attack or emphysema, significant bleeding, and low blood sugar.

As explained by WebMD, “the problem happens when distress triggers sudden weakness of the heart muscle,” saying that the distress triggers “can be caused by sudden shock or acute anxiety.”

“The heart has its mysteries, including the reason why it can suddenly grow weak because of physical or emotional stress,” the website, which publishes comprehensive information on health and wellbeing, said.

Heartbreak kills

Mayo Clinic said most people who have the condition recover fast, stressing that broken heart syndrome does not have long-lasting effects, but there is a possibility that the condition will occur again.

But while death as a result of heartbreak is rare, it is still dangerous, with Johns Hopkins Medicine saying that in some cases, it can cause severe heart muscle weakness resulting in congestive heart failure, low blood pressure, and shock.

The condition may be called stress cardiomyopathy, takotsubo cardiomyopathy, recurrent takotsubo cardiomyopathy, or apical ballooning syndrome, Mayo Clinic said on its website.

Based on what cardiologist Leni Iboleon-Dy said in a health forum in 2015, “heartbreak has an effect on the heart” and that broken heart syndrome accounts for three percent of heart diseases affecting Filipino women.

This, as it was revealed in a 2008 study that at least 30.4 percent of Filipino women suffer from cardiovascular diseases like hypertensive heart disease, aortic aneurysms, ischemic heart disease and stroke.

Based on research funded by the British Heart Foundation, which has been reported by NetDoctor, broken heart syndrome, added with severe emotional stress, can weaken the heart.

It involves the sudden weakening of the muscular portion of the heart which could be triggered by emotional stress, like hearing about the death of a loved one, or being rejected by the object of one’s affections.

READ: Love unrequited: 30% of Filipinos feel the pain — SWS

These shocks, as stressed by US-based elderly interest group AARP, can have a physical impact on the heart, causing a temporary cardiac episode, or in rare cases, even death.

The complications of the conditions, Mayo Clinic said, also include backup of fluid into the lungs, called pulmonary edema, irregular heartbeats, called arrhythmias, heart failure, and blood clots in the heart.

Symptoms

Mayo Clinic and Johns Hopkins Medicine said symptoms of broken heart syndrome include chest pain, shortness of breath, sweating, and dizziness—symptoms that mimic a heart attack.

“These symptoms may begin as soon as minutes or as long as hours after an emotionally or physically stressful event,” Johns Hopkins Medicine said, explaining that the condition is different from a heart attack.

“Most heart attacks occur due to blockages and blood clots forming in the coronary arteries, which supply the heart with blood. If these clots cut off the blood supply to the heart for a long enough time, heart muscle cells will die, leaving the heart with scar tissue and irreversible damage,” it said.

People experiencing broken heart syndrome, meanwhile, have normal coronary arteries and often do not have severe blockages or clots.

The heart cells of people experiencing the condition are stunned by the adrenaline and other stress hormones. Fortunately, this gets better very quickly in most cases, often within weeks or just a few days. Most patients don’t have scar tissue or damage.

This, as when one experiences a stressful event, the body produces hormones and proteins like adrenaline and noradrenaline that are meant to help cope with the stress.

“The heart muscle can be overwhelmed by a massive amount of adrenaline that is suddenly produced in response to stress. Excess adrenaline can cause narrowing of the small arteries that supply the heart with blood, causing a temporary decrease in blood flow to the heart,” Johns Hopkins Medicine said.

Alternatively, the adrenaline may bind to the heart cells directly, causing large amounts of calcium to enter the cells. This large intake of calcium can prevent the heart cells from beating properly.

Mending a broken heart

As Johns Hopkins Medicine said, it appears that adrenaline’s effects on the heart during broken heart syndrome are “temporary and completely reversible — the heart typically recovers fully within days or weeks.”

The condition can happen to anyone, but it’s more common among women than men, in middle age or older. People who get it usually have no history of heart trouble, WebMD said.

People who have or had anxiety or depression may have a higher risk of broken heart syndrome.

You may need medicines to manage your blood pressure and lighten some of the strain on the heart. These drugs include “water pills” or diuretics, ACE inhibitors, and beta blockers.

“Talk with your doctor about how you’ll need to take these medications,” WebMD said.

“Because your heart becomes weaker, you may be more likely to get heart failure or to have heart rhythm problems. Your doctor should talk about that with you and tell you what follow-up care you’ll need,” WebMD said.

It stressed that counseling can also help with grief or anxiety that brought on the symptoms: “Ask your doctor to recommend a therapist who can help you talk through your feelings and find ways to manage them as you face your new situation.”

Taking steps to manage emotional stress can improve heart health and may help prevent broken heart syndrome, Mayo Clinic said. Some ways to reduce and manage stress include exercise, mindfulness, and connecting with others in support groups.

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