Most people have heard the expression “dying of a broken heart.” While it sounds like a figure of speech, doctors know that a real medical condition called broken-heart syndrome does exist.
The condition can develop after an extremely stressful event and may cause symptoms that look almost identical to a heart attack.
People with broken-heart syndrome often experience sudden chest pain, difficulty breathing, and severe distress. They frequently go to the emergency department because both they and their doctors suspect a heart attack. However, tests usually show that their coronary arteries are not blocked.
Broken-heart syndrome, which is also known as takotsubo syndrome, is only one of several heart conditions that can cause heart attack symptoms without major artery blockage. Another condition, called MINOCA, also causes heart attack-like symptoms despite the absence of severe narrowing in the coronary arteries.
Although these conditions can be physically serious, they are also emotionally challenging. Many patients report experiencing major stress, anxiety, or emotional trauma before their illness begins. Others develop anxiety afterward because they fear another episode or struggle to understand why they became ill.
Despite these psychological difficulties, there are currently few recommendations for providing emotional support to these patients.
Researchers from Uppsala University and Karolinska Institutet wanted to find out whether psychological treatment could make a difference. Their study, published in the Journal of the American Heart Association, tested an online version of cognitive behavioral therapy.
Cognitive behavioral therapy is widely used to treat anxiety, depression, and stress-related problems. It teaches people to identify unhelpful patterns of thinking and develop healthier ways of responding to difficult emotions and situations. Delivering the therapy online also makes it more convenient and accessible for many patients.
The study enrolled 88 people who had recently experienced either broken-heart syndrome or MINOCA. The participants came from hospitals in several Swedish cities and joined the study shortly after developing their heart conditions.
Women accounted for 91 percent of the participants. This is not surprising because broken-heart syndrome affects women much more frequently than men, particularly after menopause.
Half of the participants received standard medical care. The other half completed a seven-to-nine-week online CBT program and also had two short telephone consultations with a psychologist.
The treatment itself was unusual because it was developed together with patients who had personally experienced these conditions. This allowed the researchers to design a program that addressed the specific worries and challenges faced by these patients.
Researchers measured levels of stress and anxiety before and after treatment using several questionnaires.
The findings showed that online CBT significantly reduced symptoms of stress and anxiety. The improvements were large enough to be considered clinically meaningful and were similar to the benefits seen in many traditional psychological treatments.
Importantly, very few participants left the program before it ended. This suggests that the treatment was practical and acceptable to patients.
One of the most interesting findings was how the therapy appeared to work. Patients did not necessarily become better at eliminating stressful situations from their lives. Instead, they became better at managing the emotional reactions caused by those situations.
This distinction matters because many stressful life events cannot be controlled. A person cannot prevent the loss of a loved one, erase a frightening experience, or avoid every conflict at work. However, they can learn ways to process their emotions more effectively and reduce the distress these events create.
The therapy seemed to work particularly well for people with broken-heart syndrome. These patients showed greater improvements than those with MINOCA.
The researchers believe that people with broken-heart syndrome may carry a heavier burden of chronic stress and therefore may have more to gain from psychological treatment. Many participants reported that their illness was triggered by major life events such as bereavement, shocking incidents, and serious conflicts.
This study provides an important reminder that heart health and mental health are closely connected. Emotional stress can affect the body in powerful ways, and recovery from heart disease may require attention to both physical and psychological well-being.
The study is relatively small and cannot answer every question. More research will be needed to understand exactly why some patients benefit more than others and which elements of therapy are most effective.
Even so, the findings are promising because they show that a simple internet-based treatment can significantly reduce stress and anxiety in a group of patients who have often received little attention.
As researchers continue to refine this approach, online psychological treatment may become an important part of care for women living with broken-heart syndrome and similar heart conditions.
If you care about heart health, please read studies about top foods to love for a stronger heart, and why oranges may help fight obesity, diabetes, and heart disease.
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Source: Uppsala University and Karolinska Institutet.
