The Denver Post

After a death, how much can a broken heart hurt survivors?

- By Marilynn Marchione

You hear it whenever someone gets sick or dies soon after losing a spouse: Was it because of a broken heart? Stress might not be to blame for former President George H.W. Bush’s hospitaliz­ation a day after his wife’s funeral, but it does the body no favors, and one partner’s health clearly affects the other’s.

A sudden shock can trigger a heart attack or something like it called broken heart syndrome. Some studies also have found that people are more likely to die soon after losing a longtime spouse.

But often the timing is mere coincidenc­e, and “broken heart” speculatio­n just fuels a neat narrative when the problem is unsurprisi­ng in an older person with underlying health issues.

In any case, the death of a loved one is a dangerous time for the surviving spouse, said Dr. Nieca Goldberg, a cardiologi­st at NYU Langone Medical Center and an American Heart Associatio­n spokeswoma­n.

“It’s really important to have a lot of other support around you,” she said. “When people are depressed after something like this happens, they may not be eating, they may ignore symptoms and want to be stoic. They’re certainly stressing and may not be getting enough rest. All of these things can set the stage for life-threatenin­g conditions.”

Bush, who will turn 94 in June, has been hospitaliz­ed since Sunday with sepsis, an infection that spread to his bloodstrea­m, probably from bacteria. It’s a serious condition at any age, but he is said to be respond- ing to treatments and recovering.

Stress weakens the immune system and can make infections harder to fend off, said several doctors not involved in his care. But Bush needs a wheelchair because of a form of Parkinson’s disease and has been hospitaliz­ed before for pneumonia and other infections.

It’s possible he ignored early signs of infection during the flurry of preparatio­ns for Barbara Bush’s funeral, said James Giordano, a Georgetown University neurologis­t and expert on the effects stress has on the body.

“It could be something as simple as that; inattentio­n led to an escalation of signs and symptoms,” he said. “He’s old, there’s no good way to put it,” so medical problems and risks are magnified by stress.

Stress has three stages, Giordano said: alarm, when the body releases “fight or flight” chemicals that can do damage; a resistance stage, like “calling out all the troops” to deal with the stress; and then fatigue or a letdown stage, when some of the body’s defenses may crash from the strain.

Even if a partner’s death is anticipate­d — as Barbara Bush’s was after she decided to focus on comfort care — “facing and going through the reality of the event” is stressful, he said.

Stress and a broken heart sometimes may get too much blame, though, when people are grieving.

Country music star Johnny Cash died four months after his wife, June Carter Cash, did in 2003. She was 73 and died of complicati­ons following heart valve surgery. He was 71 when he died of problems related to diabetes and had a neurologic­al disease for years before that.

“Broken heart” was widely speculated when Debbie Reynolds died a day after her actress-daughter, Carrie Fisher, did in 2016. An autopsy later showed that Reynolds, 84, died of a blood vessel that ruptured and caused bleeding in her brain — a kind of stroke. She also had high blood pressure and other serious medical problems for several years before that.

 ?? Provided by Sony Music Entertainm­ent ?? June Carter Cash and her husband, Johnny Cash, perform in 1968 at Folsom Prison in California. The two died less than four months apart in 2003.
Provided by Sony Music Entertainm­ent June Carter Cash and her husband, Johnny Cash, perform in 1968 at Folsom Prison in California. The two died less than four months apart in 2003.
 ?? Chris Pizzello, Associated Press file ?? Debbie Reynolds, left, and her daughter Carrie Fisher share a moment prior to the “Primetime Emmy Awards” broadcast in Los Angeles in 2011. The two died just one day apart in 2016.
Chris Pizzello, Associated Press file Debbie Reynolds, left, and her daughter Carrie Fisher share a moment prior to the “Primetime Emmy Awards” broadcast in Los Angeles in 2011. The two died just one day apart in 2016.
 ?? David J. Phillip, Associated Press file ?? Barbara and George H.W. Bush take in a baseball game in Houston in 2009. Barbara Bush died last week. The former president entered a hospital the day after her funeral.
David J. Phillip, Associated Press file Barbara and George H.W. Bush take in a baseball game in Houston in 2009. Barbara Bush died last week. The former president entered a hospital the day after her funeral.

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