This is wasabi. It is very spicy. It is not avocado. (Photo: Getty Images)

Someone once told me happiness equals reality minus expectations. For example, when you expect avocado and get wasabi instead, it can leave you very unhappy. But can it break your heart? Apparently so, according to a case report in BMJ Case Reports.

The case report described what happened to a 60-year-old woman. While attending a wedding, she ate a “large amount” of green stuff, which she thought was avocado. But it wasn’t quite everything she avo wanted.

No, instead the stuff gave her a burning feeling. Wassup with that? The green stuff was wasabi. She had accidentally eaten a “large amount” of what is also known as Japanese horseradish. The following video explains how this can make you pay up the nose, so to speak:

As the case report authors (Alona Finkel-Oron, Judith Olchowski, Alan Jotkowitz, and Leonid Barski) from Soroka University Medical Center in Beer Sheva, Israel, described, the woman soon began experiencing chest pressure that radiated down her arms. Nevertheless, rather than leave the wedding, she endured, experiencing a few hours of the discomfort. However, when a night’s sleep did not return her to her pre-wasabi state, she went to the emergency room and ended up being diagnosed with Takotsubo cardiomyopathy.

Whose cardiomyopathy? Takotsubo cardiomyopathy is otherwise known as stress-induced cardiomyopathy or “broken heart syndrome.” As I’ve written before for Forbes, with this condition, your heart literally gets broken. Your heart muscles cannot maintain its normal pumping action.

It’s called stress-induced because stress can trigger the release of adrenaline and other hormones throughout your body. This in turn may stimulate your heart muscles to pump faster and harder. This can be a great thing when the stress is a lion running after you. But like wasabi, too much of anything at the wrong time can be bad. The surge of stress hormones may overstimulate and overwhelm your heart muscles. That may make your heart muscles essentially go, “dude, I can’t handle this,” and break down.

Fortunately, in many cases, no permanent damage results. So, if you can get past the initial “heartbreak”, your heart can naturally unbreak itself, in the words of Toni Braxton, with the appropriate amount of support. Support includes ways to reduce the amount of work your heart has to do like giving medications to dilate your blood vessels, making it easier to pump blood through them.

Sometimes, though, your heart muscles can get weakened too much for too long. More severe and potentially permanent damage can result such as congestive heart failure. So, yes, you can even die from a broken heart.

Before you chuck your wasabi, keep in mind that this is case report, suggesting that it is a very rare occurrence, and you don’t know what exactly a “large amount” may mean. Moreover, while broken-heart syndrome is not super rare, it is not super common either. According to the Cleveland Clinic website, about 1 percent of the estimated number of people who have a myocardial infacrtion in 2007, “or 12,000 people would have experienced broken heart syndrome.”

The stress that leads to Takotsubo cardiomyopathy typically is emotional like losing a loved one or going through some other traumatic experience. Although eating either avocado or wasabi may be an emotional experience for many, this case report seems to be the first evidence that certain stronger-tasting foods can be triggers as well. Of course, who knows what roll the feeling of betrayal (as in “I thought you were avocado, but you just weren’t who I though you were,”) played in this case.

Don’t get me wrong. Wasabi can be great. As with so many things in life, timing is everything. Wasabi with sushi or peas can be fantastic. Wasabi as toothpaste or when you are kissing someone, maybe not. Assuming that you are not allergic to Japanese horseradish, you can still eat wasabi. You just have to be prepared for it.