‘Broken Heart’? What Really Killed Joe Paterno

The latest studies show that grief and loss can take a toll on the heart.

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When legendary Penn State football coach Joe Paterno died of lung cancer on January 22, fans and well-wishers immediately wondered whether it wasn’t just his lungs, but also his heart that had broken during his last days in Happy Valley.

Keith Dorney, one of Paterno’s former players, told the Press Democrat: “Matt Millen (another former Penn Stater) said it best: ‘Joe died of a broken heart.’ My wife said it was cancer, but I believe his demise was exacerbated by this terrible…scandal.”

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Al Golden, another of Paterno’s players who now coaches the Miami Hurricanes, seconded the opinion, saying during a radio interview: “I believe he died of a broken heart for how it ended.”

Paterno learned of his cancer diagnosis a few days before he was removed from the head coaching position he had held at Penn State for 46 years. He left the team amid the sex scandal surrounding former defensive coordinator Jerry Sandusky, who is charged with molesting 10 boys over a period of 15 years while under Paterno’s employ. Paterno was criticized for not going to authorities immediately when he was first made aware of allegations against Sandusky in 2002.

The idea that the well-loved coach died of a “broken heart” may simply be a coping mechanism for those who are still coming to grips with the scandal that ousted Paterno. Of course, it was his cancer that led to the eventual shutdown of his organs, including his heart. But is there anything to the notion of dying from a broken heart?

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Certainly, grief has been linked to an increased risk of heart attacks and depression, and Paterno may have been feeling both emotional distress and a sense of loss due to his recent diagnosis and his ignominious departure from Penn State. In 2005, researchers published intriguing results from 18 older men and women who had had heart attacks, many of them after difficult events such as the loss of a loved one. The people who had experienced a trauma were more likely to have higher levels of stress hormones — up to 34 times higher than normal levels — which can take a toll on the heart.

In a more recent study, published this month, researchers found that grief stemming from the loss of a loved one, loss of a job, or a difficult health diagnosis, can up the risk of heart attack by 21 times the day after the emotional loss.

That’s not to say that a major loss directly causes heart attacks — or that we’re fragile vessels that crumble during every difficult experience in our lives. But grief can take many forms, and some of them may lay ah heavy burden on the heart.

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Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.