(NEW YORK) — One in six people with broken heart syndrome had cancer, according to an international study across nine countries, including the U.S.The findings were published this week in the Journal of the American Heart Association.Broken heart syndrome, otherwise known as stress-induced cardiomyopathy or Takotsubo syndrome, is a real phenomenon. Emotional or physical stress causes the heart to stop pumping well. Stress could be from anything: money problems, unemployment, divorce, a bad breakup, anger, a bad infection or a recent surgery.This temporary condition causes the main heart chamber to balloon, so blood does not flow well. Chest tightness or pain and shortness of breath make people with broken heart syndrome feel like they could be having a heart attack.The reason broken heart syndrome has this effect on the heart is unknown, and in the past, doctors have written about patients with broken heart syndrome and cancer. But no one has ever looked more closely at the relationship — until now.The study looked at 1,604 people with broken heart syndrome, 267 of whom had cancer. The most common cancer was breast cancer, followed by cancers of the digestive system.Although broken heart syndrome is often thought to be related to emotional stress, physical stress is also a cause. People who had both broken heart syndrome and cancer said that they actually had less emotional stress than those without cancer. Their broken heart syndrome came after surgery or some physical trauma.This means that it could be a two-way relationship; cancer may be a physical stress that causes broken heart.“They don’t know the direct reason why there seems to be this association between cancer and the broken heart syndrome,” Dr. Nieca Goldberg, cardiologist and medical director of the Joan Tisch Center for Women’s Health at NYU Langone, said in an interview with ABC News. “But I would say that being hospitalized or treated for cancer is an emotionally stressful event, and they may have been more likely to have procedures, and this could also be a stressful event.”“Our study also should raise awareness among oncologists and hematologists that broken heart syndrome should be considered in patients undergoing cancer diagnosis or treatment who experience chest pain, shortness of breath, or abnormalities on their electrocardiogram,” Dr. Christian Templin, the study’s senior author and director of Interventional Cardiology at Switzerland’s University Heart Center Zurich, said in a statement from the Journal of the American Heart Association.“Basically more research needs to be done,” said Goldberg. “If someone comes with a diagnosis of broken heart syndrome, they shouldn’t automatically think they have cancer. They should be evaluated by their physicians. It’s another opportunity to have their normal preventive health care screening done.”Copyright © 2019, ABC Radio. All rights reserved.