Dying of fright or of a broken heart has long been dis­missed as myth, but it’s a real phe­nom­enon that one North­eastern phys­ical therapy pro­fessor and researcher has observed and studied.

The phe­nom­enon recently rec­og­nized by the med­ical com­mu­nity and named “stress car­diomy­opathy,” mimics a heart attack in that the heart is unable to pump blood to the brain or to the rest of the body. But in this con­di­tion, blood flow is not blocked and the patient usu­ally recovers with no long-​​term car­diac damage.

Referred to as “broken heart syn­drome,” stress car­diomy­opathy affects pri­marily women, typ­i­cally elderly women fol­lowing extreme emo­tion­ally stressful life events, like the death of a loved one or involve­ment in a car crash.

But the syn­drome can also occur in younger women under intense phys­ical stress. Larry Cahalin, a clin­ical pro­fessor in phys­ical therapy at North­eastern, observed broken heart syn­drome twice in a woman par­tic­i­pating in an ultra­ma­rathon cycling event, called the “Race Across America”— a 3,000-mile, West Coast to East Coast event involving cycling as many as 22 hours a day.

Cahalin, who studies heart failure and methods phys­ical ther­a­pists can use to help patients avoid and manage heart failure, studied ultra­ma­rathon cyclists for four years, mea­suring the effects of exer­cise on heart and pul­monary function.

One year, while fol­lowing a dozen riders in the last leg of the Race Across America, he observed heart failure symp­toms in a female cyclist, including marked short­ness of breath and extreme leg swelling.
He rec­om­mended she go to a hos­pital emer­gency room, where she under­went med­ical tests and was given drugs to remove the excess fluid filling her lungs, he said.

Once treated, she was fine. But a year later, she com­peted in the race again, and Cahalin observed again the onset of heart failure, but with milder symp­toms, he said.

Researchers have found that broken heart syn­drome occurs when adren­a­line over­whelms the heart in response to a life stressor, like grief, fear, extreme anger or surprise.

Broken heart syn­drome is get­ting increasing atten­tion from researchers and physi­cians. Cahalin noted that a large number of phys­ical ther­a­pists in the United States work with patients who have heart dis­ease, some of whom may have expe­ri­enced broken heart syndrome.

The con­di­tion is likely under-​​diagnosed and not com­pletely under­stood,” said Cahalin. “It mimics a heart attack in that the heart becomes unable to pump blood to the brain and the rest of the body, with the pos­si­bility of life-​​threatening heart rhythm abnormalities.”