Broken Heart Syndrome: The High Health Risk of Sudden Loss

I treat patients with heart problems – most of them are people over 50 with conditions like plaque-blocked arteries, high blood pressure or structural problems.  But on a regular basis, I also see patients who’ve had heart attacks – minor and major – with no prior history of heart problems.

In some cases these sudden heart issues were caused by what doctors often call “broken heart syndrome” – stress induced health crises that can occur after the loss of a loved one – especially a sudden, unexpected loss.  If you, or someone you know, have experienced the loss of a loved one, I’d like to talk to you about the 30 day high health risk period following…

Your 30-Day Health Risk After Sudden Loss

Recently, a patient of mine suddenly lost her husband to a heart attack.  Her grief was overwhelming and she actually wound up in the hospital.  A few days after her husband’s death, she started experiencing dizziness, tingling in her hands and feet and around her mouth.  These can all be symptoms of impending stroke.  In the emergency room, they found her blood pressure to be elevated as was her stress hormone cortisol.

She was admitted for observation for 2 days and then allowed to go home.  It turned out, in the chaos surrounding her husband’s death, she had forgotten to take her blood pressure pills regularly, which aggravated her symptoms.  Had her family not gotten her to the emergency room, she may well have suffered a stroke – perhaps catastrophically.

The “broken heart syndrome” is an all too common scenario in people who have lost a spouse, child, parent, sibling, or close friend.  It occurs most often in middle-aged and older people – age 60 and up.  But it doesn’t just involve getting ill from forgetting to take medications.  It can also come on by decreased food intake, becoming dehydrated, vomiting and sleeplessness.

People who are relatively healthy normally may also experience the same symptoms, such as that of a heart attack and/or stroke, nausea, vomiting and other gastrointestinal upsets, insomnia, depression, even mania, following the death of someone close.  Their risk goes way up in the immediate 30 days following their loss.  A study cited in the Journal of The American Heart Association says that the risk of suffering a heart attack is 21 times normal the first day of the news and 6 times greater the first week.

A recent study out of the University of St. George in London, England also found similar results.  Their study showed that the chances of someone suffering a heart attack or stroke doubles in the 30 days after their spouse’s death.  When the death was a sudden, unexpected loss, the effect can be even more traumatic on the survivor’s health.

Shock and grief set off a flood of cortisol – stress hormones – which can elevate blood pressure, heart rate, spike blood sugar levels, cause nervousness and anxiety as well as psychiatric problems like mania.  It can even change blood clotting times – slowing it down – so that you’re at higher risk of developing dangerous blood clots that can lead to stroke or heart attack.

Stress and grief may also cause insomnia, which can lead to daytime “brain fog” and forgetfulness.  As a result, people – like my patient – often forget to take their medications on a regular basis or think that they have.  Going several days without your medications can result in adverse reactions and symptoms to occur.

The University of London study found that sudden stoppage of certain medications can increase your risk of adverse heart reactions.  The researchers explained that many doctors in their study saw an increase in heart attack/stroke risk in patients in the first 30 days following the death of a spouse.

Second to spouses, are siblings.  Research published in the Journal of the American Heart Association recently reported that people were most likely to suffer a heart attack following the death of a sibling.  But the period of risk extended beyond 30 days to 4-6 years later – especially if the sibling died of a heart attack.

The study, out of the Karolinska Institut in Sweden, showed that women were 25% more likely with men 15% more likely to suffer a heart attack after the death of a sibling. The researchers concluded that poor coping responses which resulted in unhealthy lifestyles are at the core of the syndrome.

In other recent research out of Columbia University’s Mailman School of Public Health, researchers also linked sudden loss and health risks. In their study, they found that people with no prior mental illness history could suffer several psychiatric disorders triggered by sudden loss. These included depression, panic disorder, and insomnia, most commonly.  In people over age 30, losing someone unexpectedly also doubled the risk for new-onset mania, they found.

Mania is a condition marked by sleeplessness, frenetic energy and lack of inability to stay on task or concentrate on details.  It may also be marked by uncharacteristic shopping sprees, binge alcohol drinking or substance abuse, risky sexual behavior, lawlessness, anger outbursts, social disturbances, etc.

The risk increased more than 5 times in people over age 70 and this is the age group most likely to experience more frequent loss of spouse, siblings, relatives, etc. The researchers concluded that the onset of psychiatric illness in older people, with no prior history, may go hand in hand with the sudden loss of a loved one – especially a spouse or a sibling.

Losing a close loved one, whether expected or unexpected, is perhaps one of the most stressful events in your life.  As you get older, losing close loved ones also becomes more likely.  As the above studies show, the way in which you handle your grief can result in you ignoring your own health and/or engaging in poor lifestyle choices that can bring on ill-health and catastrophic results.

It’s important for friends and family to be aware of this increased health risk to people they know who’ve suffered a traumatic loss.  Offering your support – in whatever way you can – might help ensure that your friend or relative processes their grieving in a healthy way.

Remember though, grieving can take several years to completely resolve and everyone processes loss in their own way.  But friends and relatives should be aware of the signs and symptoms of “pathologic grieving”.  This is where healing doesn’t seem to be occurring at all or the bereaved seems to be getting worse rather than better.  Getting your friend or relative to a grief counselor, or even their doctor, can help them deal with their grief and decrease their health risk.

Stay Well,
Ron Blankstein, M.D.

 

 

Research Shows You Can Die of a Broken Heart, http://www.sciencedaily.com/releases/2014/02/140225101258.htm

Risk of Heart Attack Doubles after Sibling’s Death, http://www.sciencedaily.com/releases/2013/02/130227162016.htm

Grief Over Losing a Loved One Linked to Higher Heart Attack Risk, http://www.sciencedaily.com/releases/2012/01/120109212011.htm

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