When a Broken Heart Feels Like a Heart Attack

June 22, 2006 — -- This report was originally broadcast May 12, 2006.

In "Grey's Anatomy," a woman is admitted to the hospital every year, on the anniversary of a traumatic event in her life, suffering the classic symptoms of a heart attack. But it's not a heart attack. It's a medical mystery -- part of a plot twist in the show. But the fictional case is based on a nonfictional problem, and Joyce Fagan had it.

Fagan went to the hospital with heart attack symptoms on the eve of her son's wedding. "It was physical pain, it wasn't just my heart feeling sad. It was as if someone had kicked me in the chest," she said.

"Certainly, the symptoms are the same symptoms that people have when they're having a heart attack. Shortness of breath, chest pain," said Dr. Hunter Champion, a Johns Hopkins cardiologist.

But what's going on in these patients is quite different from what happens during an actual heart attack.

What caused Joyce Fagan's pain after her son's wedding rehearsal dinner was the news that her brother had died suddenly of heart failure.

"I just couldn't believe, because he had been to the rehearsal dinner ... and I became hysterical," Fagan told "20/20."

Doctors at Johns Hopkins discovered that despite her symptoms, her coronary arteries were clear. Her symptoms fit a pattern that Champion and another prominent cardiologist, Dr. Ilan Wittstein, had identified in their research. They were investigating why some emergency patients had been diagnosed with heart attacks -- although they didn't have the heart damage.

"We started seeing things that just were quite different from what you see with a heart attack. The blood work didn't add up. The electrocardiogram looked a bit different. The actual shape of the heart muscle was quite unique, different from what you see with a heart attack. These patients didn't have any blockages in their coronary arteries. There was no blood flow limitation to the heart," Wittstein said.

"At that point we started thinking about the role of stress," Champion said. "They all had very interesting stories to that effect. And we thought about the role of stress and stress hormones, like adrenaline, causing this response."