Can you really die of a broken heart?

They're the kind of romantic tragedies that make headlines.

Elderly couples who have spent their lives together remain inseparable even in their last breaths — dying within hours of each other. It happened to a couple from Crookston, Minn., recently: Eva Vevea held the hand of her husband, Clifford, one last time after he died of natural causes. Hours later, she was gone, too.

But can a person really die of a broken heart?

"It's very real," said Dr. Scott Sharkey, a cardiologist with the Minneapolis Heart Institute at Abbott Northwestern Hospital.

Doctors even have a not-so-subtle name for it: broken heart syndrome.

"Any cardiologist in town will tell you that they've seen several cases of this," Sharkey said. He studies the medical condition, which is triggered by sudden, major stress. The symptoms are similar to a heart attack: shortness of breath, chest pains, an accelerated heartbeat.

For senior citizens, this type of sudden heart injury can be especially dangerous when combined with pre-existing conditions and their age. Researchers at the University of Glasgow conducted a large study of more than 4,000 married couples, ages 45 to 64, and found that widows and widowers had a 30 percent elevated risk of death in the first six months after their spouses had died.

There's no way to know for sure if broken heart syndrome caused the death of Eva Vevea or any other elderly person who has died soon after losing a spouse, Sharkey said. But he acknowledged that it is certainly possible. Of all the triggers known to cause broken heart syndrome, "grief is certainly a powerful one."

Partners to the end

Clifford and Eva Vevea started out as dancing partners.

The couple became partners off the dance floor, too, marrying in 1947. A photo from their wedding day shows the pair standing side by side, smiling under a July sun. The same smiles appear in family photos that document a 66-year bond.

"They did everything together," said son, Clifton "Kip" Vevea.

Toward the end, they shared the same room at a local hospital and asked to have their beds pushed together.

Clifford, at 93, went first. He died from complications related to heart surgery. Ninety-year-old Eva — who had been on dialysis for years — chose to stop her treatment once her husband passed away. She died a few hours after him.

"I think the only reason my mother hung on was because of Dad," Kip said. "Once there was no chance of him surviving, she just gave up, too."

Dr. Anne Murray, a specialist in geriatrics and internal medicine at Hennepin County Medical Center, said she sees cases of elderly couples dying together all the time.

"In some cases, when someone has a chronic serious illness," she said, "some people will basically will themselves to survive until their spouse dies. And then they say, 'I'm done.' "

But not everyone dies from this peculiar condition. The Minneapolis Heart Institute has been researching cases of broken heart syndrome since 2001, and has seen 350 patients with it, Sharkey said. Of those patients, 90 percent are women.

"It's a very much female-dominant condition," he said. "We don't know why that is."

While it can be fatal, many people recover from it, he added.

First recognized in 1990 by Japanese researchers, they originally dubbed the condition "Takotsubo cardiomyopathy."

Takotsubo is the Japanese word for a pot used to trap octopus. When injured, the heart resembles this pot, according to photos taken while the organ is still beating, Sharkey explained. Cardiomyopathy refers to a disease that affects the heart muscle. The trauma experienced by subjects studied in Japan was caused by earthquakes and other natural disasters — not the loss of a spouse.

The term "broken heart syndrome" first surfaced in a 1998 study in the journal Circulation. It was based on the case of a 70-year-old woman whose husband of 45 years died suddenly. She then came down with a sudden heart condition when told of her husband's death. Doctors referred to her condition as "broken heart," Sharkey said.

She survived, and so did the term.

People are most vulnerable to the condition within the first 24 hours of experiencing sudden and major trauma, Sharkey said. The body unleashes a torrent of stress hormones that cause the heart to beat much faster.

"It's a helpful thing if you're trying to run away from a dinosaur," Sharkey said, "but if you get too much adrenaline, it will harm your heart. That's what we think is happening. The body is automatically releasing this hormone that is temporarily injuring your heart muscle."

The loss of any loved one — a child or even a beloved pet — can induce broken heart syndrome, doctors say. But it occurs most often among senior citizens.

It's possible for younger people to be afflicted, but it's less likely to kill them because younger hearts aren't as vulnerable to cardiac arrest and can recover, Sharkey said.

Such sweet sorrow

In Murray's experience of treating older couples, she's seen instances where the emotion and attachment is so strong that they can't bear to go on without their deceased partner. Under stress, certain chemicals in the body stimulate the heart to pump harder than it needs to, sometimes causing the heart to fail, she said. But even before that happens, Murray said, some couples find the strength to hang on as long as their partner is still alive.

That's what Richard "Dick" Felumlee figures happened with his parents.

Kenneth and Helen Felumlee, 92 and 91 respectively, were sweethearts since the day they met as teenagers.

Married for 70 years, the Ohio couple ate breakfast together every day while holding hands until their final moments, Felumlee said.

In recent years, they both had serious health problems. "I know they were kind of both holding on for each other. Dad, within the last week before he passed, had told a couple people who had come to visit, 'I'm hanging in there for Helen. I don't want her to be alone.' "

Helen died on April 12. Fifteen and a half hours later, Kenneth slipped away, too.

"When we told Dad that Mom had passed, he shook his head like he acknowledged it," Felumlee recalled. "Then he kind of looked at us kids and said, 'Helen's gone.'

"From that moment, you could see him fading away."

Allie Shah • 612-673-4488