Few things in life are as fierce as the love shared between romantic couples or between parent and child. For one person to lose the other can literally be heartbreaking.

We usually hear of elderly couples together for decades passing away within days of each other. One of the most high-profile examples of broken heart syndrome (up until this week) was between Johnny Cash and June Carter Cash. Johnny died less than four months after his wife, June, in 2003, reportedly over a condition that worsened because of his broken heart.

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This week, Hollywood fans have been mourning the loss of singer and actress Debbie Reynolds only a day after her daughter, actress Carrie Fisher, died of complications from a massive heart attack she suffered just before Christmas.

Reynolds, 84, devastated over Fisher’s death, was with family and in the middle of funeral preparations when she suffered a stroke. A double funeral for both mother and daughter is now reportedly being planned.

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Dying of a broken heart, or broken heart syndrome, is very real, most often occurring after an extreme emotional event. Symptoms are often similar to those of a heart attack. Victims feel chest pain, weakness, and shortness of breath. Doctors recommend that individuals in distress be monitored or that they see a doctor as soon as possible if they’re having these symptoms.

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Yet sometimes the heartbroken person literally doesn’t want that. Todd Fisher, Carrie’s brother and Reynolds’ son, said Thursday that Reynolds wanted to be with Fisher.

“She went to be with Carrie. In fact, those were the last words that she spoke this morning,” he told E! News.

“We do not yet know what happens at the time of death,” said an end-of-life expert.

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It is not uncommon for loved ones or family members to die within a short period of time of one another, said Anna Gene O’Neal, CEO and president of Alive Hospice in Middle Tennessee, and a former RN. Alive Hospice is the one of the oldest hospices in the U.S.

Stress and grief can often be overwhelming, O’Neal told LifeZette. If someone already has health issues, the stress can further compromise the body and lead to critical health issues, even death.

“It was not too long ago that we had both a husband and wife on our service and they died within minutes of each other.  Similar events have been reported through other literature sources,” said O’Neal. “Most recently, I had a close personal friend who lost his parents six weeks apart; one was expected and the other not expected. As anyone could imagine, the loss of a single loved one can be very hard. A second loss almost simultaneously isn’t just double — it seems exponential.”

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As a health care professional in settings that include both ERs and hospice arrangements, she believes there are forces beyond what we can comprehend that lead to the timing of death.

“Some people survive what seems unsurvivable, while others don’t respond to normally successful health care interventions. It doesn’t always make sense. Is it an act of God? That would be up to each individual’s belief systems to determine,” she said.” Personally, I believe there is something bigger that we do not yet know, something that happens at the time of death. One day, we will all learn.”