Doug Flutie, the legendary quarterback, lost both of his parents on Wednesday. In a Facebook post, he said that his mother Joan died of a broken heart shortly after his father Dick, who had been hospitalized, died of a heart attack.
Broken-heart syndrome is very much real, said Dr. Martin Allen Samuels, chairman of the neurology department at Brigham and Women’s Hospital in Boston. Samuels spoke about the condition and its history. This conversation has been edited and condensed.
How common is broken-heart syndrome?
If you look at giant populations, it’s happening all the time. The unifying hypothesis is that the part of the brain that’s responsible for emotional life, the limbic system, secretes adrenaline if it becomes overactive. For 999,999 people out of a million, this doesn’t kill you. But there’s a small but definite risk of it causing damage, and the heart is particularly susceptible.
How exactly do you study this?
We know that after a big stress, the risk of sudden death goes up. Earthquake is a very good model of this. It comes suddenly without warning, it’s very stressful, there’s no control over it, and it’s actually a life-threatening stress. You can look at the background sudden-death rate in a particular community, and look at it after the earthquake, and it goes up about fivefold.
But that’s different from the stress of heartbreak, no?
It’s not that different. It’s all a manifestation of something called fight and flight. Under acute stress there’s a release of adrenaline, and that chemical increases your heart rate and blood pressure, and dilates your pupils. That stress, I think, includes all these things: earthquakes, bad news — and even, by the way, powerfully good news.
There’s a case of a golfer who was playing with a partner one day and hit a hole in one. He turned to his partner and said, ‘I hit a hole in one! I can die now!’ And he did. And there was another of a guy who rolled a perfect 300 game in bowling and walked back to his partners and said, ‘I bowled a perfect game! I can die now!’ And he did.
In medical parlance, the condition is known as “takotsubo cardiomyopathy.” Why is that?
The person who described this in 1990, a Japanese guy, said that when the heart dilates it looks like an octopus-catching pot. That happens to be called a takotsubo, so he called this condition takotsubo cardiomyopathy.
Who does this most commonly afflict?
Women over the age of 65 — but we don’t know why. That’s a fact for which there’s no definite explanation.
What’s the most unusual case of this you’ve heard of or witnessed?
One of the most famous cases we know of is the case of the Siamese twins, Chang and Eng. They lived in the 19th century. They worked in the Barnum & Bailey Circus and retired to North Carolina and married a pair of sisters, and they had 21 children between them. Chang had heart disease and a stroke, and they went to sleep one night and Eng woke in the middle of the night to find his brother had died. Talk about a stressor. They were 63 years old. He turned to a nephew who was in the room, and said, ‘Your uncle Chang has died. I shall now die.’ And he did.
If you’re close to someone who you anticipate will have an extraordinarily hard time with the death of a loved one, is there any way to prevent this?
I don’t have the answer. Theoretically there are drugs and interventions one could use to reduce the sympathetic storm. All of that theoretically sounds like a good idea, but we don’t have any evidence that any of them would be powerful enough to stop an attack. Could you try to do that, though? You could.