A healthy living blog from Marshfield Clinic Health System

Is it possible to be scared to death?


“Scared to death” is very closely related to a condition called stress-induced cardiomyopathy and likely what people actually experience.

While it has been described in medical literature, its scientific basis is not fully understood. Whether there have been any true cases is unclear. A very closely-related condition called stress-induced cardiomyopathy, on the other hand, is very well described and is likely what people experience when they are scared to death.

How is stress-induced cardiomyopathy diagnosed?

It’s diagnosed in 1-2 percent of patients with suspected heart attacks. They have typical chest pain and EKG changes that make it look like the patient is having a heart attack. However, when further testing like an angiogram, which looks for blockages in the heart, rules out blockages then another test called a ventriculogram is done. A ventriculogram is a test where we take pictures of the heart’s pumping chambers. This is when stress-induced cardiomyopathy is usually diagnosed. Sometimes an echocardiogram can suggest this, too, if done first.

The typical heart is shaped like a cone. When the heart beats the entire cone compresses equally. In stress-induced cardiomyopathy, the middle to the tip of the cone balloons out as opposed to squeezing in and gives the heart the shape of a narrow-necked pot. It’s also called “Takotsubo cardiomyopathy.” Takotsubo comes from Japan where this condition was first described and means “octopus trap.” In this type of trap, the octopus enters the pot but cannot come out because of the narrow neck.

Who is at risk for stress-induced cardiomyopathy?

This is more commonly seen in older women and people ages 60-80. Extreme emotional distress due to loss of a loved one, serious accident, financial issues or learning of a devastating illness can all lead to stress-induced cardiomyopathy.

The exact reason why the body responds this way is not known but it is believed the “fight or flight” response may be involved. The “fight” reflex occurs subconsciously and causes chemicals, called catecholamines, to be released into the body. Catecholamines can have severe effects on heart blood vessels and the actual muscle itself.

What can you do for stress-induced cardiomyopathy?

Thankfully, now that we better understand this condition, therapies used in treating acute heart failure and those that generally help in heart function recovery are also used to treat stress-induced cardiomyopathy. The good news is that if you survive the acute illness, which can be dangerous, then the heart function usually improves over one to four weeks.

So, as you prepare to celebrate Halloween, be careful about scaring grandma!

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