How can we die of a broken heart? The physiology.

Back to a less controversial subject, how we die from a broken heart. The syndrome of Takotsubo's cardiomyopathy is interesting since it may account for the death of people who are so upset about a subject for a length of time that they actually die, much like we sometimes see when patients die soon after the passing of a loved one. Takotsubo's was first described in Japan thus it got its name, tako tsubo or octopus trap. An octopus trap is shaped such that the octopus can crawl in the trap but can't get out. It is like a wine carafe where the neck is narrow and the decanter is broad. This is what happens to the heart when someone has a lot of adrenaline floating in their system from stress, the outlet of the heart can remain narrow as the body of the heart becomes bulbous, making it difficult to emit blood. On angiogram the coronary vessels appear normal but there may be a correlation with the length of the front coronary artery, the left anterior descending artery, and risk of developing takotsubos cardiomyopathy. From the adrenaline there may be microvascular obstruction to blood flow in parts of the heart that are important for emitting blood. Patients often present with symptoms of a heart attack but can sometimes present with heart failure for otherwise unknown reasons. The treatment is with beta blockers or calcium channel blockers which can alter the strength of heart contractions and protect the heart from detrimental effects of adrenaline. This is how one could die from a broken heart.