Cardiomyopathy: How stress affects your heart

Everyone gets stressed at one time or another, but prolonged or sudden, acute exposure may be harmful. Uncover the causes, recognise the signs, and explore strategies to safeguard your heart from the impacts of chronic stress.

Uncover the causes, recognise the signs, and explore strategies to safeguard your heart from the impacts of chronic stress.

“Stress is an inherent part of life, as it helps your body to prepare for the demands of daily existence,” says Dr Andile Xana, a cardiologist practising at Mediclinic Heart. “However, chronic stress can have far-reaching consequences, affecting your mental and physical wellbeing. One consequence is stress-induced cardiomyopathy, a condition that occurs when a person experiences sudden acute stress that can rapidly weaken the heart muscle.”

Stress-induced cardiomyopathy is also known as broken heart syndrome, takotsubo syndrome, and apical ballooning syndrome.

What causes stress-induced cardiomyopathy?

The exact cause of stress-induced cardiomyopathy is not known. “Symptoms are often triggered by extreme emotional stress, such as anger, surprise, or grief – which is where the name broken heart syndrome comes from – as well as physical stress from severe infections or major surgery. Hormones released during stress may affect the heart's ability to pump blood,” says Dr Xana.  Certain factors may increase the risk of developing this condition, including being a postmenopausal woman and having no history of heart disease.

Signs and symptoms of stress-induced cardiomyopathy

A common symptom of stress-induced cardiomyopathy is sudden chest pain that is often mistaken for a heart attack. Other symptoms are shortness of breath, irregular or fast heartbeat (arrhythmia), fainting, and low blood pressure.

Diagnosing stress-induced cardiomyopathy

Diagnosing stress-induced cardiomyopathy involves a combination of symptoms, medical history, and various tests, including blood tests to check troponin levels, an electrocardiogram (ECG) to assess electrical activity in the heart, and an echocardiogram to visualise heart function, says Dr Xana. Imaging tests, such as a coronary angiogram, ventriculogram, chest X-ray, MRI, and CT scan, may also be conducted to gather comprehensive information.

Treatment of stress-induced cardiomyopathy

Treatment may include anti-anxiety drugs, ACE inhibitors, angiotensin receptor blockers, diuretics, and beta-blockers. Lifestyle interventions, such as stress management and weight loss, are also recommended. Treatment may also be necessary for complications arising from the stress-induced cardiomyopathy, such as heart failure, shock, or heart rhythm issues.

"Understanding the potential impact of stress on heart health is crucial,” says Dr Xana. “Stress-induced cardiomyopathy, or broken heart syndrome, demonstrates how extreme stress can affect the heart muscle. Recognising the signs, seeking timely medical intervention, and managing your stress are key to mitigating the risks associated with this condition.”

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