Can happiness break your heart?

Can a person die from happiness? The answer is yes, as a new study has warned that too much joy can break your heart.

The study suggests that happy events can trigger a heart condition known as takotsubo syndrome (TTS), aka broken heart syndrome, which is characterised by a sudden temporary weakening of the heart muscles that causes the left ventricle of the heart to balloon out at the bottom while the neck remains narrow, creating a shape resembling a Japanese octopus trap, from which it gets its name.

Since this relatively rare condition was first described in 1990, evidence has suggested that it is typically triggered by episodes of severe emotional distress, such as grief, anger or fear, with patients developing chest pains and breathlessness. It can lead to heart attacks and death.

Now, for the first time, researchers have systematically analysed data from the largest group of patients diagnosed with TTS worldwide, and found that some patients have developed the condition after a happy or joyful event; they have named it "happy heart syndrome".

The team analysed data from 1,750 patients diagnosed with TTS in nine different countries. Of 485 patients for whom definite emotional trigger could be identified, 96 percent had suffered sad and stressful events such as the loss of a loved one, attending a funeral, being hurt in an accident, or experiencing an illness or relationship problems. One obese patient was stricken after getting stuck in the bath.

But in the case of the remaining 20 individuals, heart damage appeared to have been triggered by happy occasions including a birthday party, wedding, surprise celebration, the birth of a grandchild, or a favourite rugby team winning a game.

Jelena Ghadri from University Hospital Zurich in Switzerland said the new findings should lead to a paradigm shift in clinical practice. "We have shown that the triggers for TTS can be more varied than previously thought. A TTS patient is no longer the classic "broken hearted" patient, and the disease can be preceded by positive emotions too."

Ghadri noted that clinicians should be aware of this and also consider that patients who arrive in the emergency department with signs of heart attacks, such as chest pain and breathlessness, but after a happy event or emotion, could be suffering from TTS just as much as a similar patient presenting after a negative emotional event. Our findings broaden the clinical spectrum of TTS. They also suggest that happy and sad life events may share similar emotional pathways that can ultimately cause TTS."

The study appears in the European Heart Journal.