Diagnosis

Broken heart syndrome is often diagnosed in an emergency or hospital setting because symptoms mimic a heart attack.

To diagnose broken heart syndrome, the health care provider examines you and asks questions about your symptoms and medical history. You may be asked if you've had any major stresses recently, such as the death of a loved one.

People who have broken heart syndrome usually don't have any heart disease symptoms before the condition is diagnosed.

Tests to help diagnose broken heart syndrome include:

  • Blood tests. People who have broken heart syndrome often have higher levels of substances called cardiac enzymes in the blood.
  • Electrocardiogram (ECG or EKG). This quick test measures the electrical activity of the heart. Sticky patches called electrodes are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which shows the test results.

    An ECG shows how fast or how slow the heart is beating. ECG results for broken heart syndrome look different from those for a heart attack.

  • Coronary angiogram. This test checks for blockages in the heart arteries. It's done to rule out a heart attack. People with broken heart syndrome often don't have any blockages. A health care provider inserts a long, thin flexible tube called a catheter in a blood vessel, usually in the groin or wrist. It's guided to the heart. Dye flows through the catheter to arteries in the heart. The dye helps the arteries show up more clearly on X-ray images and video.

    Once it's clear that you're not having a heart attack, the health care provider checks to see if your symptoms are caused by broken heart syndrome.

  • Echocardiogram. This test uses sound waves to create pictures of the beating heart. It shows how blood flows through the heart and heart valves. It can see if the heart is enlarged or has an unusual shape. These changes may be a sign of broken heart syndrome.
  • Cardiac MRI. This test uses magnetic fields and radio waves to create detailed images of the heart.

Treatment

There's no standard treatment for broken heart syndrome. Treatment is similar to heart attack care until the diagnosis is clear. Most people stay in the hospital while they get better.

Many people with broken heart syndrome fully recover within a month or so. An echocardiogram is done about 4 to 6 weeks after the first symptoms to make sure the heart is recovered.

Medications

Once it's clear that broken heart syndrome is the cause of the symptoms, medicines may be given to reduce the strain on the heart. They also help prevent further episodes.

Medicines may include:

  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Angiotensin II receptor blockers (ARBs).
  • Beta blockers.
  • Diuretics.
  • Blood thinners, if there is a blood clot.

Surgeries or other procedures

Surgeries and procedures that are often used to treat a heart attack aren't helpful in treating broken heart syndrome. Such procedures open blocked arteries. Blocked arteries do not cause broken heart syndrome.

Preparing for your appointment

Broken heart syndrome is usually diagnosed in an emergency or hospital setting.

If possible, have a family member or friend come with you to the hospital. Someone who goes with you can help you remember the information you're given.

If possible, share important information with the person taking you to the hospital:

  • Any symptoms you're having, and how long you've had them.
  • Your important personal information, including any major stresses, such as the death of a loved one, or recent life changes, such as the loss of a job.
  • Your personal and family medical history, including health conditions such as diabetes, high cholesterol or heart disease.
  • A list of the medicines you take, including those bought without a prescription.
  • Any recent injury to your chest that may have caused damage inside the body, such as a broken rib or pinched nerve.

At the hospital, you may have many questions. If possible, you may want to ask:

  • What do you think is causing my symptoms?
  • I recently experienced the sudden death of a loved one. Could my symptoms be due to this event?
  • What kinds of tests do I need?
  • Do I need to stay in the hospital?
  • What treatments do I need right now?
  • What are the risks associated with these treatments?
  • Will this happen again?
  • Do I have any diet or activity restrictions?

Don't hesitate to ask any additional questions.

What to expect from the doctor

A health care provider who sees you for chest pain may ask:

  • What symptoms are you having?
  • When did the symptoms begin?
  • Does your pain spread to any other parts of your body?
  • Does your pain briefly get worse with each heartbeat?
  • What words would you use to describe your pain?
  • Does exercise or physical activity make your symptoms worse?
  • Do you have a family history of heart problems?
  • Are you being treated or have you recently been treated for any other health conditions?
Oct. 27, 2022
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