Ruth and Harold “Doc” Knapke met in elementary school. They exchanged letters during the war, when Doc was stationed in Germany. After he returned their romance began in earnest. They married, raised six children and celebrated 65 anniversaries together. And then on a single day in August 2013, in the room they shared in an Ohio nursing home, they died.

“No relationship was ever perfect, but theirs was one of the better relationships I ever observed,” says their daughter Margaret Knapke, 61, a somatic therapist. “They were always like Velcro. They couldn’t stand to be separated.”

For years, Knapke says, she and her siblings watched their father’s health crumble. He suffered from longstanding heart problems and had begun showing signs of dementia. He lost interest in things he once enjoyed, and dozed nearly all the time. “We asked each other, why do you suppose he’s still here? The only thing we could come up with was that he was here for Mom,” she says. “He’d wake up from a long snooze and ask, ‘How’s your mother?’ ”

Then Ruth developed a rare infection. Lying unconscious in the nursing-home room she shared with Doc, it became clear she was in her final days. The Knapke children sat down to tell Doc that she wasn’t going to wake up again. “He didn’t go back to sleep. I could see he was processing it for hours,” says Margaret. He died the next morning, and Ruth followed that evening.

Knapke sees her parents’ same-day deaths as a conscious decision—two hearts shutting off together. “My feeling was that he was hanging around for her,” she says. Knapke believes her father wanted to show her mother the way to the next realm. “He knew she needed something else from him, so he switched gears and let go,” she says. “I feel he chose to go first so he could help her. It was definitely an act of love on his part.”

The Knapkes’ story may be special, but it’s not unique. Every few months, some small-town paper publishes a similar human-interest story. Last July, People magazine ran the story of 94-year-old California residents Helen and Les Brown, who were married for 75 years. They’d been born on the same day and died just one day apart. In February, a photo of New York residents Ed Hale, 83, and his wife Floreen, 82, made the rounds on social media. The image showed the couple holding hands through the railings of their side-by-side hospital beds. They died mere hours apart.

Death by heartbreak is a literary staple; even Shakespeare wrote of “deadly grief.” The emotional devastation of losing a loved one can certainly feel like physical pain. But can you really die from a broken heart? As it turns out, you can, from “broken-heart syndrome,” also known as stress-induced cardiomyopathy. Studies of bereavement, in fact, provide another harsh indictment of the effects of stress on human health. But deadly grief is not about stress alone, scientists say. It shines a light on the physiological bonds of love, ceded to us by evolution, so often best understood when broken.

Studies from around the world have confirmed that people have an increased risk of dying in the weeks and months after their spouses pass away. In 2011, researchers from Harvard University and the University of Yamanashi, Tokyo pooled the results of 15 different studies, with data on more than 2.2 million people. They estimated a 41 percent increase in the risk of death in the first six months after losing a spouse. The effect didn’t just apply to the elderly. People under 65 were as likely to die in the months following a spouse’s death as those over 65. The magnitude of the “widowhood effect” was much stronger for men than it was for women.

The explanation for the gender difference may be simple logistics. Particularly in previous generations, women did more of the work caring for their husbands and households. They kept in touch with adult children and were in charge of the family social life, says Tracy Schroepfer, a professor of social work at the University of Wisconsin-Madison, who studies the psychosocial needs of terminally ill elders and their families. When their wives died, men were more likely to become isolated. “Loneliness was really great, and for men who couldn’t shop and cook for themselves, it could impact their nutrition and health,” she says.

While women might be more resilient to losing a spouse, however, they aren’t immune to the deadly effects of grief. A 2013 study of more than 69,000 women in the United States found that a mother’s risk of dying increased 133 percent in the two years following the death of a child.

The idea that grief can increase the risk of dying makes intuitive sense, especially among those who spend time with the ill, says Roy Ziegelstein, a cardiologist and vice dean of education at Johns Hopkins University School of Medicine. “I think that if you polled doctors, they’d overwhelmingly tell you it happens not infrequently.”

Yvonne Matienko, a nurse and holistic health coach from Pennsylvania, knows all about broken-heart syndrome. Matienko was 51, without any history of heart problems, when she received a shocking phone call. Her teenage granddaughter, with whom she lived, had been involved in a serious car crash. Matienko rushed to the scene. “When I saw the trauma people and helicopters and the kids laying on the highway, my heart started racing,” she says.

Later that night, relieved that her granddaughter would be okay, she poured a glass of wine and tried to relax. Suddenly, she was overcome by dizziness. Then she passed out. “That’s the last thing I remember,” she says. Matienko was rushed back to the hospital, where she was diagnosed with stress-induced cardiomyopathy.

Unlike a heart attack, broken-heart syndrome doesn’t stem from blocked arteries. It appears to be brought on by a sudden surge in stress hormones including epinephrine (more commonly known as adrenaline) and its chemical cousin norepinephrine. That rush of hormones is a normal, healthy response to extreme stress. It fuels the body’s famed “fight or flight” response that prepares you for dealing with major threats. But in some cases the sudden flood of hormones essentially shocks the heart, preventing it from pumping normally. On an X-ray or ultrasound, the heart’s left ventricle appears enlarged and misshapen. The unusual shape is said to resemble a Japanese octopus trap called a tako-tsubo, hence the syndrome’s other alias: Takotsubo cardiomyopathy. The syndrome doesn’t permanently damage the heart’s muscle tissue, and patients often make a full recovery. A year after her ordeal, Matienko has no lingering heart problems. Still, the condition can be deadly if the misshapen heart can’t pump enough blood to the rest of the body.

Grief can affect the heart in less immediate ways. British researchers recently analyzed data from more than 30,000 surviving spouses in a primary care database from the United Kingdom. According to the study, published in February in JAMA Internal Medicine, the risk of heart attack and stroke doubled during the first 30 days after a spouse’s death......

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