Lifestyle

How stress can break women’s hearts, literally

Published on 26 September 2025

Broken Heart Syndrome shows how emotional shock can damage the heart. Stress and depression raise the stakes, especially for women.

A broken heart can be fatal.

In Takotsubo cardiomyopathy, or Broken Heart Syndrome, sudden shock or grief floods the body with stress hormones. The surge stuns the heart muscle.

It mimics a heart attack, but the arteries are often clear. And it strikes women most.

Heart disease is already the world’s leading killer of women, according to the World Health Organization. Depression pushes that risk even higher.

“Depression increases the risk of heart disease, more so in women compared to men,” said Dr Lim Yoke Ching, Senior Consultant at the National University Heart Centre, Singapore (NUHCS). The danger intensifies at key life stages such as pregnancy, the post-partum months and menopause, when hormones and mood leave the heart more exposed.

How depression harms the heart

Depression does not just bring low mood. It can wear down the body and the heart.

Stress hormones such as cortisol stay high, while inflammation builds up. “This ongoing inflammation can cause fatty deposits in blood vessels, a process known as atherosclerosis,” said Dr Lim.

Blood also becomes “stickier”, making clots more likely and raising the risk of a heart attack. The nervous system can go into overdrive too, which has been linked to heart failure.

On top of that, depression drains energy. Medication gets missed, exercise stops, and some turn to smoking or alcohol. Over time, the pressure on the heart piles up.

When hormones tip the balance

Hormones add to the risk. Oestrogen usually shields the heart, but levels drop after menopause. That protection fades, while stress and mood problems rise — a double hit for the heart.

Pregnancy and the months after birth also bring danger. “Mood disorders after childbirth are not uncommon. Stress-induced heart problems in the post-partum period are rare but can still be serious,” said Dr Lim. Studies suggest post-partum depression may also raise the risk of heart disease later in life.

Broken Heart Syndrome explained

Doctors call it Takotsubo cardiomyopathy, or Broken Heart Syndrome.

It often comes on suddenly with chest pain, breathlessness or even collapse. The symptoms resemble a heart attack, but scans usually show clear arteries. “Coronary angiograms in Takotsubo patients typically do not reveal significant arterial narrowing,” said Dr Lim.

The condition is far more common in women, especially after menopause. Falling levels of oestrogen are thought to play a part.

What is Broken Heart Syndrome?

Medical name
Takotsubo cardiomyopathy

What happens
The heart muscle suddenly weakens, often after shock or grief

How it feels
Symptoms mimic a heart attack — chest pain, breathlessness, fainting

Key difference
Coronary arteries are usually not blocked

Who is at risk
More common in women, especially after menopause

Why it matters
Most recover, but it can cause complications — and shows how tightly stress and heart health are linked

The symptoms that women miss

Chest pain and breathlessness are classic signs of a heart attack. But women often show up differently.

“Women may also experience nausea or vomiting, back, neck or jaw pain, unusual fatigue, dizziness, excessive sweating and stomach pain,” said Dr Lim.

Because these symptoms can be mistaken for flu, stress or tiredness, many women delay seeking help. That delay may cost lives.

Myths and misconceptions

A common belief is that depression only harms the heart through bad habits like overeating or inactivity.

In fact, “Depression itself has been linked to inflammation and abnormal platelet activation, both of which can lead to heart disease,” said Dr Lim.

Even women who eat well and exercise may still face increased risk if depression or anxiety goes untreated.

Protecting both heart and mind

There are no early screening tests to detect hidden strain in women with depression. What matters is controlling known risks factors such as blood pressure, cholesterol and diabetes.

The basics go a long way: eat balanced meals, exercise regularly, maintain a healthy weight, avoid smoking and excess alcohol, get enough sleep and manage stress in healthy ways.

But for women with depression, these habits are harder to stick to. Energy drops, motivation fades and daily routines slip. Planning ahead, setting reminders and leaning on family or community support can make the difference. Small steps add up over time.

“Looking after mental health is part of looking after the heart,” Dr Lim emphasised.

Six habits to protect your heart

Move: At least 150 minutes of moderate exercise each week
Eat: More fruits, vegetables, wholegrains and lean proteins; less sugar, salt and saturated fat
Sleep: Aim for eight hours of good-quality rest
Manage stress: Use outlets like exercise, mindfulness, social support, time in nature
Quit: Avoid smoking and limit alcohol
Check: Monitor blood pressure, cholesterol and blood sugar regularly

In consultation with Dr Lim Yoke Ching, Senior Consultant, Department of Cardiology, NUHCS.