People have long known that emotional trauma can affect the body, especially the heart. One heart condition, often called “broken heart syndrome,” is known to occur after a person experiences extreme emotional stress. Following the outbreak of the Israel–Gaza conflict in October 2023, doctors in southern Israel noticed a sudden rise in these heart-related cases. This trend led to a focused investigation by medical teams connected to Ben-Gurion University of the Negev.
Dr. Sharon Bruoha and his team carried out the study at Barzilai Medical Center in Ashkelon and Soroka Medical Center in Beer Sheva. These two hospitals care for many people living in areas affected by the conflict. The findings are featured in the medical journal ESC Heart Failure, which reviews and publishes health-related research.
Several cases of emotionally triggered broken heart syndrome were recorded during the first and most intense stage of the conflict. This was far more than what had been seen during the same time the year before. At Barzilai Medical Center, this condition represented a noticeable share of all emergency heart-related hospital visits. The increase was not a minor change—it marked a significant shift. Similar patterns were observed at Soroka Medical Center. Each patient’s heart event could be linked to a highly stressful experience caused by the war, such as rocket warning sirens, hearing nearby explosions, losing a family member in battle, or facing armed attackers inside their home.
Nearly all patients were women, mostly in their early sixties, though some were significantly younger. These younger patients were not part of the age group doctors typically associate with this type of heart problem. All of them went through deep emotional shock, and the medical team described this feeling as a “perceived risk of annihilation”—an intense fear for their lives. The study emphasized the seriousness of these cases, with patients showing clear signs of heart damage and elevated stress levels. “All patients experienced episodes of intense fear stemming from a perceived risk of annihilation, representing an exceptionally intense psychological upset,” Dr. Bruoha explained.
Troublingly, this heart condition—usually seen as mild and short-lived—presented a much more dangerous pattern in these cases. The heart’s ability to pump blood was severely reduced in every patient. Several also experienced serious complications, including heart valve problems, fluid in the lungs known as pulmonary edema, and even complete heart stoppage, referred to medically as cardiac arrest. “In the current series, all patients presented with high-risk features. Such ominous clinical presentation is in contradiction to the benign phenotype reported in large cohorts of patients with emotionally triggered Takotsubo cardiomyopathy,” Dr. Bruoha noted.
Doctors observed that the majority of these cases occurred within the first few weeks after the fighting began. As time went on, even though the conflict continued, fewer new cases were reported. This pattern suggests that people may become somewhat emotionally desensitized or more mentally adjusted over time, even if the external danger remains. “Interestingly, the majority of patients presented within the first 3 weeks of the conflict, with only one patient detected at the end of the period of monitoring, despite the continuing acts of terror,” Dr. Bruoha observed.
Patients in this group also included some younger adults, and about half had a prior diagnosis of a mental or brain-related condition, such as anxiety or neurological disorders. This connection suggests that people with these conditions may be more likely to experience severe heart reactions under extreme emotional stress. Although younger individuals typically have less serious responses to emotional trauma, the prolonged fear during a national crisis may have altered that usual pattern.
Dr. Bruoha and colleagues emphasized that events like war can lead to serious health problems that extend far beyond physical injuries. The findings show that people do not need to be physically harmed in a conflict to face life-threatening consequences. “Importantly, a severe national crisis may precipitate a form of Takotsubo cardiomyopathy—a temporary heart condition often brought on by stress—with high-risk features, at a younger age, and with potentially poor outcomes in comparison with Takotsubo cardiomyopathy induced by emotional stressors related to personal calamities,” Dr. Bruoha concluded.
Journal Reference
Bruoha S., Star A., Givaty G., Shilo M., Friger M., Chitoroga V., Shmueli H., Abramowitz Y., Asher E., Jafari J., Shlyakhover V., Zahger D., Haim M., Yosefy C. “Takotsubo cardiomyopathy during armed conflict: A case series.” ESC Heart Failure, 2025; 12: 1494–1498. DOI: https://doi.org/10.1002/ehf2.15080
About the Author
Dr. Sharon Bruoha is a cardiologist based at Barzilai University Medical Center and an affiliated faculty member at Ben-Gurion University of the Negev in Israel. With a focus on cardiovascular health, she has developed a strong clinical and academic profile in the diagnosis and treatment of heart diseases, particularly those linked to emotional and psychological stress. Her research interests include the connection between mental trauma and heart function, a field where she has contributed valuable insights through both clinical care and scientific studies. Dr. Bruoha has played a central role in recent investigations exploring how large-scale crises, such as armed conflict, affect heart health in civilian populations. She is recognized for her collaborative work with multidisciplinary teams and her commitment to advancing knowledge in stress-related cardiovascular conditions. Her dedication to patient care and research makes her a leading voice in understanding the intersection between emotional trauma and cardiac health.
