How emotional overload during the holidays can mimic a heart attack

Why do the holidays trigger this heart condition?

For many, the holidays bring joy, connection, and traditions. For others, however, the season’s rush, expectations, and heightened emotions can push the heart to its limits, literally. 

Cardiologists at Loma Linda University International Heart Institute say they see a spike in cases of stress-induced cardiomyopathy every year between November and January. 

“This condition can look and feel exactly like a heart attack,” says Megan Pelter, MD, advanced heart failure and transplant cardiologist. “Chest pain, shortness of breath, abnormal EKGs — everything points to a heart attack. But when we go in and look, their coronary arteries aren’t blocked.”

Stress-induced cardiomyopathy, often called Takotsubo syndrome or “broken heart syndrome,” is a temporary weakening of the heart muscle triggered by a sudden surge of stress hormones.

“Cardiomyopathy means the heart muscle simply isn’t pumping the way it should,” Pelter says. “What surprises people is how fast it can strike, sometimes over just a few days, and in the right circumstances, within moments of a major emotional or physical shock.”

Unlike traditional cardiomyopathy, which often develops after decades of plaque buildup, Takotsubo hits fast, and the trigger may not always be tragic.

What stress can cause it?

“We’re taught to think it only happens after devastating news like a death in the family,” she says. “But I’ve seen it after arguments, intense holiday pressure, even during happy moments like graduation. Anything that causes a strong surge of adrenaline can set it off in the right person.”

The emotional load of the season, like family dynamics, travel, financial strain, and hosting pressure, can magnify stress more than people realize. Pelter says what surprises her most is how ordinary holiday moments can precede an episode. 

“I’ve admitted patients after heated arguments at the dinner table or stress while shopping in crowded stores,” says Pelter. “They come in convinced they’re having a heart attack, and in some ways their body is responding like they are, just without the blocked artery.” 

Who is most at risk?

During each holiday season, clear patterns emerge among patients who develop stress-induced cardiomyopathy. Older adults, especially women, tend to be most affected, and the risk rises even more for those already managing conditions like diabetes, kidney disease, or lung problems. Emotional isolation and simmering family tension can further heighten vulnerability. 

The biggest invisible threat, however, is sleep deprivation, a factor many people overlook despite its significant impact on heart health. Pelter explains that most people don’t realize how damaging poor sleep is to the heart. “Being up late shopping, traveling, or scrolling on your phone keeps your stress hormones elevated. Good sleep truly protects the heart,” she says.

What are the symptoms?

The symptoms of stress-induced cardiomyopathy mirror a heart attack so closely that anyone experiencing them should call 911. Pelter urges people that if they feel any of these symptoms, they should get checked by a doctor to rule out a heart attack. 

Those symptoms include:

• Sudden chest pain

• Shortness of breath

• Trouble lying flat

• Swelling in legs

• Feeling faint or weak

The good news about stress-induced cardiomyopathy is that most people recover fully. “Most patients recover over weeks to months with medications and close follow-up,” Pelter says. “The key is managing stress and staying on top of all your heart-healthy habits.” 

What can I do to protect the heart?

What protects the heart the most during the holidays is a non-negotiable habit such as regular physical exercise. The heart is a muscle, and exercise buffers the effects of stress.

Additional tips for this season:

• Set realistic expectations for the season

• Take intentional breaks during busy days

• Prioritize sleep (no phones before bed, consistent sleep schedule)

• Avoid excess salt and heavy holiday meals

• Continue all prescribed medications, even while traveling

• Shift emotional focus

“There’s so much good that comes with the holiday season,” Pelter says. “Connection, gratitude, quality time — these positive emotions support psychological and cardiac wellbeing. Focusing on what truly matters can be protective.” 

When should I talk to a doctor?

Stress-induced cardiomyopathy may resolve, but unchecked stress does not. Managing stress, staying active, and following up with your doctor are essential — not just to prevent cardiomyopathy, but to protect your long-term heart health.

Take this season as a reminder to check in on  your heart health  with the help of experts at Loma Linda University International Heart Institute. Schedule a preventive heart screening or talk to your doctor about your risk factors. Learn more at  lluh.org/heart-vascular .