Hearts are used to symbolize love on Valentine’s Day and all year long. In real life, our feelings and sense of love lost or loneliness due to a breakup, divorce, rejection or death might just impact us physically, as well as emotionally and mentally.

This state of mind can even lead to Broken Heart Syndrome, “also called stress-induced cardiomyopathy or takotsubo cardiomyopathy,” which researchers are just “starting to learn the causes, and how to diagnose and treat it,” according to the American Heart Association’s website, heart.org. “It could even happen after a good shock (like winning the lottery).”

Also, the site states, “Broken heart syndrome may be misdiagnosed as a heart attack because the symptoms and test results are similar. In fact, tests show dramatic changes in rhythm and blood substances that are typical of a heart attack. But unlike a heart attack, there’s no evidence of blocked heart arteries in broken heart syndrome.”

Even though this condition can sometimes “lead to severe, short-term heart muscle failure,” it is usually treatable, according to heart.org. “Most people who experience it make a full recovery within weeks, and they’re at low risk for it happening again (although in rare cases it can be fatal).”

Cardiologist Katharine Decena of Hartford HealthCare Medical Group said during a telephone interview that “certain mental health problems can have symptoms that manifest as heart issues. So, for example, patients who are anxious and have histories of panic attacks feel like they’re having heart attacks.”

She said their goal is to “rule out coronary disease” before considering mental/emotional distress situations. “It’s not something to take lightly. At the office, we do see a lot of patients who manifest with a lot of cardiac symptoms.”

Then after completing their workup, she said often “nothing organic” is found. After a while, Decena said patients do admit to being under a lot of mental and emotional stress “from home and work situations.”

“Regarding suicide/depression and heart disease, we can say that patients with heart disease now live longer with modern therapy,” Decena said in an email. “Depression may develop as an effect of new limitations to their previous quality of life, sometimes exacerbated by little social support or being/feeling isolated because of their chronic illness. There are some authors who reviewed the topic of depression and CV disease and suggested that biologic variables associated with depression include elevated catecholamine levels (stress hormones), increased inflammation and dysfunction of the lining of our vessels, all of which contribute to cardiovascular disease. It is unknown whether depression causes heart disease or heart disease causes depression.”

“Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States,” according to the Centers for Disease Control and Prevention’s website, cdc.org. “One person dies every 36 seconds in the United States from cardiovascular disease. About 659,000 people in the United States die from heart disease each year—that’s one in every four deaths.”

Decena said heart attack symptoms can present differently in men and women. Typical symptoms include shortness of breath and “some chest pain when you exert yourself,” which is “relieved by rest or with medication like nitroglycerin. That’s not always the case with women, not just heart attacks, but heart disease in general.”

Other heart attack symptoms people may experience include nausea, vomiting, sweating and pain or discomfort in one or both arms, the jaw, neck, back or stomach, according to heart.org. Call 911 if you are experiencing any of these symptoms.

If someone thinks they are having a heart attack, Decena said they could take four baby aspirins (enteric) or one regular aspirin. This can help delay “further damage to the heart, but not necessarily the symptoms,” she said. Warning: Before taking any aspirin, she said people should check with their primary doctor or cardiologist to ensure it won’t harm them because of their medical history.

“With strokes and heart attacks, the common theme there is any accumulation of plaque in our vessels can rupture and can cause an acute or a sudden decrease of blood flow to that portion of the body. So if it’s in the heart vessel, it would cause a heart attack. If it’s in our neck or brain arteries, it can cause a stroke.”

Decena said hypertension (high blood pressure) should be watched closely. Our blood vessels “get a little bit stiffer” as we age and become more sedentary. This condition can also develop “if we don’t watch our salt intake,” or if we have a genetic predisposition to it.

Monitoring our cholesterol numbers annually as part of a regular routine primary care visit, makes up a big portion of cardiovascular prevention, with or without heart disease, she said.

“So getting it checked at least once a year, and talking with your doctor” (to discuss) if cholesterol medication is right for you would be advisable. “If the cholesterol numbers are high, their physicians can guide them in determining what their risk would be for cardiovascular disease” and if they “would benefit from a cholesterol medicine,” which “may be key in not only reducing the amount of bad cholesterol in the body that contributes to plaque buildup, but also keeping any plaque stable and stuck to the wall so that it does not rupture.”

Sedentary individuals might want to consider leaving shoveling and snow plowing to the professionals. Dr. Decena said some studies “have shown that shoveling would even exceed the amount of workload on a cardiac stress test. Add to that it is physiologically cold outside. Our vessels would spasm and contract, constrict from the cold.”

Blood is then shunted to our peripheries, “because we need the warmth in our hands and feet, because that’s what’s moving a lot. And so it’s all a perfect storm that contributes to heart attacks: the physical condition of the individual, the environment and the amount of workload that shoveling puts on our bodies.”

She recommends people who’ve had heart attacks and have low heart muscle function from it “should probably not shovel at all.”

There may also be a link between sleep and cardiovascular disease, according to a paper in the American College of Cardiology that Decena cited in an email. The 2020 study followed about 2,000 people who did not have active cardiac disease.

“The findings suggested that participants with the most irregular sleep duration had a greater than twofold increase in developing disease over that period of time,” Decena said.

In addition to getting a good night’s sleep, a healthy lifestyle includes stress management, good diet, good mental health and exercise.

“There is still merit (in) all of these small changes that we make. And all the good decisions that we make throughout our life also do accumulate and contribute to a longer life and better quality of life.”

Perhaps we would be healthier and experience less burnout if we followed the two-hour siesta tradition of some European countries, Decena said: That time can be utilized for rest, as well as pursuing other interests, and then return to work refreshed.

She recommends eating a lot more plant-based foods, such as vegetables, legumes and nuts, and getting our protein from plants rather than from animals. Meat choices should be palm-sized servings (4-to-6-ounce servings) of lean chicken, pork or beef.

Also, salmon and tuna are especially good for us, because they contain fatty acids with Omega-3 and Omega-6, which our bodies need. Other fish like haddock and cod are also healthy for us; they just don’t contain much Omega-3. For healthier carbohydrates, substitute sweet potatoes for white ones. Try whole wheat, red-lentil or gnocchi pasta, which provide more soluble fiber, compared to the traditional, white starchy pasta. Additionally, choose plant-based olive, sunflower and canola oils instead of tropical ones. When supermarket shopping, avoid processed foods by staying on the outer aisles where the fresh produce and dairy products are.

Decena said she is concerned about people’s health during the pandemic.

“With patients being depressed and also not being able to do the things that they take pleasure in, they can develop unhealthy habits that can increase their risk for coronary disease. They become more sedentary. They would probably be eating more (unhealthy) snacks when they’re sitting and watching TV.”

She suggested, “If you have friends that you can talk to about your mental health problems, you will most likely be less anxious” and “feel loved and seen,” which also greatly contributes “to a person’s wellbeing overall, not just not just cardiac-wise,” she said adding, “We were not made to be isolated creatures.”

“Sitting is the new smoking,” she said, emphasizing the importance of moving for good health. “So continue getting up several times an hour,” which has been made easier with Smart watches to remind us.

Her tips include taking the stairs instead of the elevator as much “as you can manage,” parking farther away from stores when shopping to get more steps in, walking around a mall or your neighborhood and getting a dog, which will force you to walk.

Also, consider purchasing a standing desk.

Cardiologist Katharine Decena of Hartford HealthCare Medical Group is affiliated with Backus and Windham Hospitals.

Jan Tormay, a longtime Norwich resident, now lives in Westerly.