Wasabi, the popular Japanese condiment served alongside sushi, has an intense, spicy heat that can easily make your eyes water if you eat too much at once. So, imagine the surprise one woman felt when she consumed an entire spoonful at once, after confusing it with avocado.
The woman, a 60-year-old living in Israel, experienced sudden pressure in her chest, which eventually subsided, but when she was still feeling unwell the next day, she went to the emergency room.1 In a case report detailed in BMJ Case Reports, researchers explain that the woman arrived at the emergency department with chest pain,2 where doctors thought she might be having a heart attack.
However, further testing revealed that her heart was misshaped, making it unable to pump blood properly. This is characteristic of takotsubo cardiomyopathy, a condition named for a Japanese octopus fishing pot — a takotsubo — which the heart resembles in its misshapen form.3
Another name for the condition is stress-induced cardiomyopathy or broken heart syndrome, because it often occurs in response to intense physical or emotional stress, such as the loss of a loved one.
Wasabi Leads to Broken Heart Syndrome
The BMJ case report is, to the researchers’ knowledge, the first report of broken heart syndrome triggered by wasabi. Eating a large amount of this spice could easily lead to intense physical symptoms, as even a small amount can cause a painful sensation in your sinuses and burning in your mouth.
The reason wasabi (Wasabia japonica), a member of the Brassicaceae family, commonly called the mustard family, is so hot is due to a defense mechanism of the plant — pests stay away since it’s so unpleasant when consumed. However, most “wasabi” is not actually the Japanese root of the same name but actually a mixture of horseradish, hot mustard and green food coloring.
Still, the shock of consuming so much of this spicy condiment could, indeed, “break” your heart, as occurred in the woman’s case. “Takotsubo cardiomyopathy is a left ventricular dysfunction that typically occurs after sudden intense emotional or physical stress and mimics myocardial infarction [heart attack],” the researchers explained.4
Stressors that may lead to broken heart syndrome include not only the loss of a loved one but also experiencing a natural disaster, an accident or an attack, among others. Serious illness, such as intracranial hemorrhage and sepsis, as well as pregnancy and sexual intercourse have also been known to trigger this syndrome.5 Other stressors associated with takotsubo cardiomyopathy include:6
Loss of a pet
Receiving bad news
A sudden surprise, such as a surprise party
Broken heart syndrome is much more common in women than men, with 90% of cases occurring among women aged 58 to 75 years, although it can even occur in children.7 Overall, it’s suggested that about 2% of people who have symptoms of acute coronary syndrome actually have takotsubo cardiomyopathy, although this increases to 10% if only women are considered.8
Death of a Pet, Zumba Linked to Broken Heart Syndrome
Any type of extreme physical or emotional stress could theoretically stress your heart to the point that it “breaks.” Aside from consuming a spoonful of wasabi, this could also occur due to an intense workout, such as Zumba.
In a case report of a 38-year-old woman — younger than the typical age for this condition — researchers explained that the woman went to the emergency room due to chest pain that started after an intense two-hour Zumba workout.9 She had no other stressful events that would have been likely triggers. The researchers explained:10
“Our patient did not have one clear trigger for her overt Takotsubo cardiomyopathy other than the Zumba activity. Zumba is considered an activity with excessive sympathetic stimulation leading to catecholamine-induced microvascular spasm or through to direct myocardial toxicity, which is postulated to be behind the pathophysiology of Takotsubo cardiomyopathy.”
The New England Journal of Medicine also presented a case report of a 61-year-old woman who went to the emergency room with chest pain and was later diagnosed with takotsubo cardiomyopathy.11 She indicated that she’d experienced multiple stressors, including the death of her dog.12 When her pet, a 9-year-old Yorkshire terrier, died, “’I was close to inconsolable,’ she told The Washington Post.”13
Release of Stress Hormones and the Brain May Be to Blame
As for why an intensely stressful experience can cause your heart to stop working properly, it likely has to do with the release of stress hormones. This can occur from both positive and negative stressors. According to the Cleveland Clinic:14
“A person’s reaction to such events causes a release of stress hormones (catecholamines) that temporarily reduce the effectiveness of the heart’s pumping action, or cause it to contract too forcefully or wildly instead of in a steady pattern … The impact of stress hormones ‘stuns’ the cells of the heart, causing them to malfunction.”
That being said, having a history of neurological problems, such as seizure disorders and/or a history of mental health problems is thought to raise your risk.15
It’s also recently been suggested that the brain may play a role in takotsubo cardiomyopathy and in people with the condition, regions of the brain linked to emotional processing and control of heartbeat, breathing and digestion may not communicate the way they do in people without broken heart syndrome.16,17
Study author Christian Templin, professor of cardiology at University Hospital Zurich, said in a news release:18
“For the first time, we have identified a correlation between alterations to the functional activity of specific brain regions and TTS [takotsubo cardiomyopathy], which strongly supports the idea that the brain is involved in the underlying mechanism of TTS.
Emotional and physical stress are strongly associated with TTS, and it has been hypothesized that the overstimulation of the autonomic nervous system may lead to TTS events.”
As mentioned, symptoms often mimic those of a heart attack and include:19
Sudden, severe chest pain (angina)
Shortness of breath
Irregular heartbeat (arrhythmia)
Low blood pressure
Typically, patients with takotsubo cardiomyopathy are treated with medications to lower blood pressure and decrease fluid buildup. Symptoms usually resolve within a matter of days or weeks, with no permanent damage to the heart muscle remaining.
In most cases a typical heart attack occurs due to blockages in the coronary arteries that stop blood flow and cause heart cells to die, leading to irreversible damage. But people with broken heart syndrome often have normal arteries without significant blockages. The symptoms occur due to the emotional stress, so when the stress begins to die down, the heart is able to recover.
Most people who experience broken heart syndrome won’t experience it again, but it does recur in about 10% of cases.20 While most people recover fully, it can be fatal or lead to other complications. As noted in Clinical Autonomic Research:21
“The syndrome is usually reversible; nevertheless, during the acute stage, a substantial number of patients develop severe complications such as arrhythmias, heart failure including pulmonary edema and cardiogenic shock, thromboembolism, cardiac arrest, and rupture.”
In Most Cases, Wasabi Is Good for You
Assuming you eat wasabi as most people do — in small quantities at a time — it can be quite good for you. There’s no reason to fear that it could cause extreme stress to your heart, as long as you don’t overdo it. Remember, in most cases, when you eat wasabi, you’re primarily consuming horseradish.
The heat and flavor come from allyl isothiocyanate (ITC), which is formed when the root is grated finely. The ITCs in horseradish and wasabi were found in clinical trials to reduce “colon, lung and stomach cancer cell activity by 28%, 17% and 44%, respectively.”22
Wasabi’s isothiocyanates may also help prevent platelet aggregation,23 which is the clumping together of red blood cells that may lead to blood clots that are risk factors for stroke and other cardiovascular diseases.
Wasabi also has antibacterial activity, including against E. coli O157:H7 and Staphylococcus aureus, two of the major causes of foodborne disease outbreaks.24 Other compounds in wasabi may help to fight inflammation as well. This includes 6-(Methylsulfinyl)hexyl isothiocyanate (6-MSITC), which has anti-inflammatory, antimicrobial, antiplatelet and anticancer effects.25
Because cultivating true wasabi plants is difficult, real wasabi is much harder to find (and more expensive) than wasabi imposters. Still, if you can’t find real wasabi, you can still reap many of the same benefits by eating wasabi made from horseradish — just seek out high-quality versions that do not contain artificial flavors or colors or additives such as genetically engineered corn and soy.
Can Broken Heart Syndrome Be Prevented?
Clearly, not eating a large amount of wasabi at one time is recommended not only to avoid broken heart syndrome, but also to avoid unnecessary discomfort. However, as far as preventing broken heart syndrome goes, there are no guarantees. Because this condition is linked to extreme physical and emotional stress, you can help to avoid it by managing your stress levels on a daily basis.
The Emotional Freedom Techniques (EFT) is one of the best options for doing so. Mindfulness-based stress reduction techniques like mindfulness meditation are also helpful, and applying Buteyko breathing, which involves breathing through your nose, not your mouth, also really helps to calm the mind and get into deep states of relaxation.
Sometimes extreme stress is unavoidable, but managing daily stress is one way to protect your overall health from its ill effects. In any case, if you experience chest pain after a stressful event — even something like eating wasabi — it’s a good idea to get medical help right away to rule out a heart attack or broken heart syndrome.