The death of Debbie Reynolds just one day after her daughter Carrie Fisher passed away is a reminder of the crushing effect grief can have on the body.
The 84-year-old Oscar-nominated performer reportedly suffered a stroke Wednesday. The official cause of death has not yet been disclosed.
"She wanted to be with Carrie," her son Todd Fisher told Variety.
"Broken heart syndrome," or stress-induced cardiomyopathy is a very specific medical condition that has been well-documented in recent years. It can be caused by an intense emotional event, like the death of a loved one, giving a public speech, or even from a surprise birthday party. And many times broken heart syndrome has been blamed in cases when one spouse dies soon after the other.
According to Dr. Ilan Wittstein, assistant professor of medicine at the Johns Hopkins University School of Medicine, when the condition strikes, a part of the heart muscle is suddenly weakened and the heart isn't pumping, becoming ineffective. However, the condition is usually treatable, and rarely fatal.
"Grief is so complicated because there's physiology, there's self-care and then there are a lot of unknowns," Dr. Sharonne Hayes, professor of medicine and cardiovascular diseases at the Mayo Clinic, told TODAY. "Medicine doesn't entirely understand how grief and hope affect people's life."
Among her own patients, Hayes has seen a number of people suffer from broken heart syndrome. Both acute grief as well as chronic sadness can affect the heart, Hayes said. Grief increases some stress hormones, and it can raise blood pressure and heart rate.
Stress in general can also play a role in strokes. The hormones from stress can cause plaque that is already in the artery to rupture. Dr. Wittstein explains that there is a way for broken heart syndrome to cause a stroke. When a large portion of the front wall of the heart isn't pumping as effectively the blood remains stagnant. Blood has to be moving and if it doesn't it begins to clot. The clot can then break loose and can go to the brain.
Stress also causes elevated blood pressure, which makes people more prone to strokes, and it has been shown to increase inflammation, which is also a risk for cardiovascular disease. The more common kind of stroke, an ischemic stroke, is caused by a blood clot that blocks a blood vessel in the brain.
Self-care also plays a role in handling grief. Hayes, who was not involved in Reynolds' treatment, but commented on the effect of grief in general, said it's unknown what chronic medical conditions Reynolds might have had. Caregivers often don't take very good care of themselves while at their loved one's bedside.
"Did she skip medications? Not eat? Not stay hydrated?" Hayes noted. "That's an element as well."
Some of it may also be a will to live. People who are ill often have mental or emotional "targets" for living: "I want to make it through my kid's birthday" or see them graduate or get married or celebrate Christmas. Take those targets away, and it's a shock.
"I think spirituality and optimism and resilience has a part in this," Hayes said.