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    image by telegraph.co.uk

    The death of famous actress Debbie Reynolds one day after her famous actress daughter Carrie Fisher makes one wonder how the effect of grief can cause serious physical consequences.


    Carrie Fisher, 60, famous for her role as Princess Leia in the Star Wars movies, passed away shortly after suffering a massive heart attack and subsequent cardiac arrest on a plane. The day after she passed away, her mother, Debbie Reynolds of “Singing in the Rain” and many other movies was killed by a massive stroke at the age of 84.


    Debbie’s son, Todd Fisher, commented that “She wanted to be with Carrie”.


    From time to time, you’ll hear reports about a person who experienced the death of a loved one (usually a spouse) dying of “grief”. Is there, indeed, a “Broken-Heart Syndrome”?


    Yes, there is. It’s a well-known medical issue called stress-induced cardiomyopathy. Stress-induced cardiomyopathy is more common in older women and not always fatal. The death of a loved one isn’t always the cause. It could be any other stressful event: Getting bad personal news, a major financial setback, or even having to speak publicly could precipitate symptoms.


    What happens physically in these circumstances? It’s not completely understood, but high levels of stress hormones called “catecholamines” like epinephrine (adrenaline) could possibly cause significant physical symptoms. One of these is an inability of the heart to effectively pump blood. If blood remains in one place for too long, it clots. The clot may travel to the brain, with a stroke as the end result.


    Although “Broken-Heart Syndrome” occurs most often in those with healthy hearts, those with coronary artery disease may be at special risk. High amounts of stress hormone might cause plaques that partially block a blood vessel to break free. Complete blockage of a coronary artery may occur, leading to a heart attack.


    Other factors in play include the increase in blood pressure that occurs in stressful situations. A very high blood pressure is a common cause of strokes, where a clot or hemorrhage in the brain stops blood flow to the organ. Heartrates also rise in the face of an unexpected event; abnormally fast rhythms may cause medical issues.


    Depression also has a role in “Broken-Heart Syndrome”. The grieving survivor might begin to neglect their own health, failing to take prescribed medications or not keeping up with food and fluid intake. Dehydration, loss of control of diabetes or hypertension, and other issues may arise. The shock of a loved one’s death might cause a person to not seek prompt, life-saving medical care.


    I, myself, was in this situation with my son, who was fading after 2 years of dialysis from severe type 1 Diabetes. I found myself less concerned with my own health and was beginning to feel the effects of situational depression. Luckily for both of us, he was able to receive a kidney and pancreas transplant at the last moment, and I was spared Debbie Reynold’s prospect of burying a child.


    Family members who have a death in the family (say, a parent) should watch for physical signs and symptoms in the surviving parent or other affected loved ones. These include chest pain, fast heart rates (also called tachycardia), depression, and lack of attention to hygiene and medical conditions. All are important signs that the grieving party needs extra help staying healthy and some emotional support.


    I can’t say if Debbie Reynolds had other medical problems that contributed to her death. At 84 years old, it might be just a coincidence that she passed away so soon after her daughter. But “Broken-Heart Syndrome” exists, and the importance of family and friends’ roles in providing vigilant support can’t be underestimated.


    Joe Alton, MD



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