Woman Gets 'Broken Heart Syndrome' After Mistaking Wasabi for Avocado—Here's How That's Possible

Wasabi is known to be strong and spicy. But can consuming it make a person feel like they're having a heart attack? That's what happened to one woman, who mistook wasabi for avoado at a wedding and ended up in the ER with a heart condition called "broken heart syndrome."

The story, newly detailed in BMJ Case Reports, involves a 60-year-old woman who went to the ER complaining about chest pain. At a wedding a day earlier, she had popped something in her mouth that she assumed was avocado. You can imagine her surprise when It turned out to be a teaspoon-sized hunk of wasabi, a Japanese horseradish made with mustard greens.

A few minutes later, she said she experienced a sudden pressure in her chest that radiated to her arms. The discomfort lasted for several hours, but she toughed it out at the wedding. The next day, while other guests were no doubt nursing their hangovers, she was still feeling weak and achy.

Finally, the woman went to the ER. Her heart and lungs sounded normal, doctors reported, but she was given a smattering of tests over the next two days: an ultrasound, two EKGs (an electrocardiogram, which measures the electrical activity of the heartbeat), blood tests, an angiography (an X-ray that looks at blood vessels), and an echocardiography (another test for heart function).

The outcome? She had takotsubo cardiomyopathy—aka “broken heart syndrome.” Docs don’t fully understand broken heart syndrome, the authors point out, though it’s often caused by physical or emotional stress, as well as neurological disorders, rare tumors of the adrenal glands, or drugs. Previously, they thought the only way food could trigger Broken Heart would be if someone had a severe allergic reaction to what they ate.

For someone going through broken heart syndrome, the symptoms make you feel as if you’re having a heart attack, but you’re not. There’s no blockage of arteries. Instead, there is a “temporary dysfunction of heart tissue,” Ilan Wittstein, MD, a cardiologist at Johns Hopkins Hospital in Baltimore, said in a previous Health article. Stress hormones like adrenaline are believed to be involved, which is why a stressful event usually triggers it.

“Any kind of sudden stress response can cause weakening of heart muscle, whether it's sudden fear—–someone holding a gun to your head–or the distress your body goes through in the middle of a bad infection or stroke,” said Dr. Wittstein.

In the case of this report, the super spice from the wasabi may have caused her stress pathways to go into overdrive, leading to broken heart syndrome.

Sufferers are often white, postmenopausal women, and those with anxiety or depression may be particularly at risk, as medications to treat these conditions alter the metabolism of adrenaline. Luckily, most make a full recovery. “The heart muscle is stunned and not killed, so you don't have permanent cell death of heart tissue,” said Dr. Wittstein.

The authors of the case study call the amount of wasabi the woman ate “unusually large,” and that’s true—you don’t just outright eat a teaspoon-sized ball of the stuff; it’s usually a small smear across the roll, at least to start. Still, you don’t have to give sushi takeout the stink eye from now on. “To the best of our knowledge, this is the first report of takotsubo cardiomyopathy triggered by wasabi consumption,” the authors write. (Whew, your spicy tuna roll is off the hook.)

As for the woman, she needed to take meds, like an ACE inhibitor and beta blockers, to help her heart function return to normal—and she had to go to a cardiac rehabilitation center. All because of wasabi.

No doubt it’s a wedding she’ll never forget. Luckily, one month later, she was okay. Still, she’s probably never eating wasabi again—and double checking every time she sees an avocado.

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