“Don’t Break My Achy Breaky Heart.”

These lyrics were from a famous 90’s song by the artist Billy Ray Cyrus. I remember listening to this song prior to attending medical school. I also remember being reintroduced to this song when one of our attending doctors began singing it during grand rounds one morning. Grand rounds were times during my training when all the medical students would come together with the experienced doctors to learn about cases in the hospital. 

On this particular occasion, we learned about a patient who had suffered Broken Heart Syndrome! This was my first experience with gaining knowledge and understanding of this condition. Initially, I thought the doctor was kidding, but we learned that this is a true condition recognized by the American Board of Cardiologists. 

I listened closely as the presenting doctor read the report of our single 52-year-old patient. She reported to the emergency room with symptoms of chest pain and shortness of breath. On the initial evaluation, the possible diagnosis of heart attack was established due to symptoms, an abnormal EKG, and elevated cardiac enzymes. The patient was sent to the cardiac catheter lab for a test examining the blood flow to the blood vessels supplying her heart. To the surprise of the healthcare providers, there was no blockage. The patient then had an echocardiogram, which is a test allowing visualization of the heart. The echocardiogram showed characteristic ballooning of the left ventricle of the heart consistent with the diagnosis of Broken Heart Syndrome. 

The presenting physician then shared the most interesting part of the presentation. He shared details of his conversation with the patient after she was admitted for observation when all the testing was done. He shared that the patient was a single school teacher. The patient shared that the precipitating event was a very disturbing phone call from her boyfriend which occurred one day before Valentine’s Day. 

The physician told us that the patient had a hard time informing him about the phone call due to uncontrollable crying. According to the doctor, the patient revealed that the boyfriend told her that he was not going to be able to see her for Valentine’s Day because he was going to leave her for his true love. Our attending reported that the lady told him that the boyfriend had been dating both of them the whole time but had to make a choice for Valentine’s Day. 

Broken Heart Syndrome affects females more often than males, and most have a recent history of traumatic life stressors, often emotional in nature. These may include a recent break-up or divorce, death of a loved one, or a significant financial loss. The syndrome has also been reported in people experiencing an overwhelming shock such as winning the lottery. In our patient’s case, the sudden loss of her relationship was the shocking cause. 

Broken Heart Syndrome rarely causes death or long-term damage. Most people with this condition recover quickly within a month. For some, there can be complications to include pulmonary edema, low blood pressure, irregular heartbeats, heart failure, or blood clots. Those with these complications are more likely to be patients that suffer from preexisting heart disease. 

For heart health, prevention is key. Billy Ray Cyrus sang it well in his song “Achy Breaky Heart”: “You can tell the world you never was my girl / You can burn my clothes when I’m gone / Or you can tell your friends just what a fool I’ve been.” Later, he pleaded, “Don’t tell my heart, my achy breaky heart.”

Let’s avoid Broken Heart Syndrome this Valentine’s Day, and the rest of the year.