Rejection really can break your heart, scientists warn

BOSTON — Rejection can easily crush one’s soul, but it turns out it can be physically damaging too. Researchers say that being dumped really can break your heart, causing what’s known as “broken heart syndrome.”

That’s because overwhelming stress, such as rejection or grief, triggers neurons that regulate the organ. These nerve cells are found in the amygdala, the area of the brain that also controls emotions. They are linked to the blood pumping muscle, and too much activity increases the risk of “broken heart syndrome,” explain researchers from Massachusetts General Hospital. The condition, known medically as Takotsubo syndrome (TTS), is potentially fatal.

“We show that TTS happens not only because one encounters a rare, dreadfully disturbing event—such as the death of a spouse or child, as the classical examples have it. Rather, individuals with high stress-related brain activity appear to be primed to develop TTS—and can develop the syndrome upon exposure to more common stressors, even a routine colonoscopy or a bone fracture,” says senior researcher Dr. Ahmed Tawakol, director of Nuclear Cardiology and co-director of the Cardiovascular Imaging Research Center at MGH, in a statement.

The condition, first described in 1990, is rare and mostly seen in women. It can happen when people or pets die, during medical treatment, after a job loss, divorce, breakup or romantic betrayal. It may even occur after a good shock, such as winning the lottery. According to Harvard research, more than 90% of reported cases occur in women ages 58 to 75. Symptoms can mimic those of a heart attack. In fact, up to 5% of women who are thought to be suffering a heart attack are actually battling TTS.

Stress-lowering drugs or other therapies, such as meditation, could combat the life threatening disorder.

Tawakol says warning signs can be present years in advance. His team analyzed detailed images of the brains of 104 patients from combined PET and CT scans. Their average age was 68, and almost three quarters were women. It was a stressful period as they were undergoing cancer tests, including having their bone marrow checked.

Among the participants, 41 were diagnosed with broken heart syndrome within six months to five years of the examination. They had higher stress-related activity in the amygdala compared to those who did not subsequently develop it.

What’s more, the greater the signal, the greater the risk of TTS.

“The increased stress-associated neurobiological activity in the amygdala may play an important role in its development and predict the timing of the syndrome,” says Tawakol, per SWNS. “The top 15% with the very highest amygdala activity developed TTS within a year of imaging. Those with less elevated activity developed TTS several years later.”

The average time to the last follow-up or death for the 63 controls was almost three years.

“We also identified a significant relationship between stress-associated brain activity and bone marrow activity in these individuals,” adds Tawakol. “Together, the findings provide insights into a potential mechanism that may contribute to the ‘heart-brain connection’. Areas of the brain that have higher metabolic activity tend to be in greater use. Hence, higher activity in the stress-associated tissues of the brain suggests the individual has a more active response to stress. Similarly, higher activity in the bone marrow reflects greater bone marrow metabolism.”

The study in the European Heart Journal suggests reducing stress-related brain activity could prevent TTS.

“These findings add to evidence of the adverse effect of stress-related biology on the cardiovascular system,” says Tawakol. Findings such as these underscore the need for more study into the impact of stress reduction or drug interventions targeting these brain regions on heart health.In the meantime, when encountering a patient with high chronic stress, clinicians could reasonably consider the possibility alleviation of stress might result in benefits to the cardiovascular system.”

SWNS writer Mark Waghorn contributed to this report.