News of the death of the husband of one of the victims of last week’s Texas school shooting has created more anguish in a community already mourning a devastating loss.

Irma Garcia was one of 21 people killed in Uvalde. Just days later her husband, Joe Garcia, died after returning home from her memorial. While some family members have said he died of a heart attack, others have said it was a broken heart – or Takotsubo cardiomyopathy as it’s known medically.

Both scenarios are plausible, explained Katie Connolly, assistant professor of medicine and cardiologist and heart failure specialist. Either a heart attack or Takotsubo could be triggered by a very stressful life event, she told CTVNews.ca.

“Ultimately, it’s obviously a horribly tragic situation. In the best of times, with all the best information, it can be hard to differentiate if this is Takotsubo versus a heart attack.”

While the syndrome was believed to be very rare, it may not be as uncommon as once thought. Data suggests two or three per cent of presentations that look like a heart attack are actually Takotsubo, Connolly said.

Unlike in a heart attack, there are no blocked coronary arteries in Takotsubo. Tests show abnormal changes to the heart’s left ventricle, which stop it from pumping effectively. It is not totally clear what causes the change but there are several symptoms with differing severity.

“There’s a big range — from mild chest pain or trouble breathing, which would be very common symptoms, to significant dysfunction of the heart or even dangerous arrhythmias where the heart goes too fast,” said Connolly. Sweating and dizziness can also be present.

In the case of Joe Garcia, an autopsy is required to determine the actual cause of death, she said.

“Obviously the timing can’t be ignored, and he was another victim of this horrible scenario.”