By all accounts, Debbie Reynolds and Carrie Fisher were very close in recent years, and death from a broken heart is a well-established occurrence, both in medical literature and throughout the folklore of the earliest human communities.
No one can know if actress Debbie Reynolds — who died on Wednesday, a day after her daughter, Carrie Fisher — died of a broken heart. Reynolds, 84, had suffered from several health problems in recent years, and doctors said any number of factors could have contributed to her death, possibly from a stroke.
But by all accounts, she and her daughter were very close in recent years, and death from a broken heart is a well-established occurrence, both in medical literature and throughout the folklore of the earliest human communities.
One form of the phenomenon is called Takotsubo syndrome, after the Japanese term for “octopus trap,” because the heart looks as if it is caught from below, its upper chambers ballooning as if trying to escape.
The sudden loss of a child or spouse, perhaps foremost among life’s cruelties, sets off “an overflow of stress hormones, and the heart can’t take it,” said Dr. Suzanne Steinbaum, director of women’s heart health at Lenox Hill Hospital in New York. “It appears to be a massive heart attack,” but, she said, “the heart is literally stunned.”
The octopus trap can grab any heart, healthy or not, young or old, and most people survive, doctors say. The sudden flood of stress hormones causes a temporary weakening of the heart muscle itself, unlike a classic heart attack, in which a clot blocks blood flow.
“I’ve seen estimates that about 1 percent of perceived heart attacks” are because of broken-heart syndrome, said Dr. Anne Curtis, chair of medicine at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, “and that seems about right. I think every cardiologist has seen cases. We tell people that many will return to normal or near-normal heart function.”
Reynolds’ did not, though the timing of her death may have just coincided with her daughter’s. In her 2013 memoir, Reynolds wrote about suffering a mini-stroke and experiencing partial kidney failure. In 2015, she was awarded an honorary Oscar but was too sick to attend the ceremony.
Fisher, 60, died Tuesday after suffering a heart attack on a flight from London to Los Angeles a few days earlier. On Wednesday, Reynolds was rushed to an emergency room amid reports she had possibly had a stroke.
“She said, ‘I want to be with Carrie,’ ” Todd Fisher, Reynolds’ son, told The Associated Press. “And then she was gone.”
If indeed a stroke was the primary cause of death, as Todd Fisher has said, a heart squeezed by the sudden loss of a beloved daughter could have contributed. The stunned organ, especially in a person who might have had any of the underlying cardiovascular infirmities of aging, could increase the likelihood of a clot forming and moving to the brain.
In a 2005 paper in The New England Journal of Medicine, doctors at Johns Hopkins University School of Medicine reviewed cases of 18 women and one man who landed in coronary-care units in Baltimore, between 1999 and 2003, with chest pains and no signs of classic heart attack on exam. Most were older, but one was 27 and another 32. The doctors, led by Dr. Ilan Wittstein, nicknamed the condition Broken-Heart Syndrome and noted that it occurred not only after grief but after any sudden stress. All of the patients survived.
Wittstein said that at the time the paper appeared virtually the only mentions of the syndrome were in Japanese medical literature. Now, he said, thousands of cases have been reported, and about 90 percent of them are women in middle age or older. One possible reason, he said, is that estrogen protects the heart’s smaller vessels — those most affected by stress hormones — and estrogen levels drop with age.
To some medical experts, what Reynolds experienced is one of the greatest traumas of all.
“No one wants to change the order of nature; that is the first thing I thought when I heard,” said Dr. Victor Fornari, a psychiatrist at Northwell Health on Long Island. “A parent outliving a child — it’s one of the most unspeakable things there is.”