It’s already been proven that intense emotional distress—say, after losing a loved one—can trigger a cardiac abnormality called “broken heart syndrome.” But now new research suggests sudden bursts of joy can have the same effect. The condition, known as Takotsubo syndrome (TTS), occurs when the base of the heart’s left ventricle balloons and becomes partially paralyzed. TTS is rarely fatal but causes a rapid and severe weakening of the heart that brings on chest pain and breathlessness— symptoms akin to those of a heart attack.

After analyzing 485 cases of the syndrome linked to emotional events, researchers in Switzerland found that 96 percent were caused by sadness and stress, but 4 percent were provoked by ostensibly happy occasions, such as weddings and birthdays, The Washington Post reports. It’s unclear exactly how extreme emotions damage the heart, but cardiologists suspect a surge of adrenaline may be to blame. “We believe TTS is a classic example of an intertwined feedback mechanism,” involving the psyche, brain, and cardiovascular system, says study author Christian Templin of University Hospital in Zurich. “Perhaps both happy and sad life events share common pathways in the central nervous system.”

According to the Center for Disease Control and Prevention, cardiovascular disease, particularly heart attacks and strokes, are the number one disease killer in the United States.

  • Cardiovascular disease accounts for nearly 801,000 deaths in the US. That’s about 1 of every 3 deaths in the US.
  • About 2,200 Americans die of cardiovascular disease each day, an average of 1 death every 40 seconds.
  • Cardiovascular diseases claim more lives each year than all forms of cancer and Chronic Lower Respiratory Disease combined.
  • About 92.1 million American adults are living with some form of cardiovascular disease or the after-effects of stroke.

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