A rare heart condition often linked to extreme stress may be more fatal for men than women, according to a new study published in the Journal of the American Heart Association.
Known medically as takotsubo cardiomyopathy, or “broken heart syndrome,” the condition is marked by symptoms like chest pain, palpitations, and shortness of breath. It typically occurs when a surge of stress hormones stuns the heart muscle, mimicking a heart attack.
While the condition has been observed more frequently in women, recent research analyzing nearly 200,000 U.S. hospital cases from 2016 to 2020 found that men—who made up just 17% of patients—had a significantly higher mortality rate of 11.2%, more than double that of women.
“This gender gap in outcomes is striking,” said Dr. Mohammad Reza Movahed, coauthor of the study and clinical professor of medicine at the University of Arizona. “It raises new questions that deserve further investigation.”
Takotsubo cardiomyopathy is triggered by sudden emotional or physical stress—ranging from the death of a loved one to intense physical strain or even a surprise event like winning the lottery. The heart’s left ventricle temporarily weakens, impairing its ability to pump blood effectively.
Researchers believe hormonal differences may play a key role. Men typically produce higher levels of stress hormones—called catecholamines—which may result in more severe cardiac reactions. In contrast, estrogen, found in higher concentrations in women, may offer protective cardiovascular effects.
Social factors could also contribute. Some doctors may overlook TC in men due to its strong association with women, delaying diagnosis and treatment. Men may also delay seeking medical help, assuming symptoms will subside.
“Most physicians know about takotsubo, but many still think of it as a woman’s disease,” said Dr. Deepak Bhatt, director of Mount Sinai Fuster Heart Hospital. “That misconception can lead to misdiagnosis and worse outcomes.”
If not treated promptly, broken heart syndrome can result in serious complications including blood clots, stroke, heart failure, and cardiac arrest. Early diagnosis is crucial. When caught in time, TC is often fully reversible within weeks with appropriate medication.
The study adjusted for several health variables such as age, race, and underlying conditions like diabetes and lung disease. However, it didn’t include outpatient data or deaths that occurred after hospital discharge, suggesting the true scope may be even broader.
Dr. Louis Vincent, a cardiology research fellow at the University of Miami, said the findings underscore the need for better data and further research into why men are more vulnerable.
“Big datasets help reveal population-level trends,” he noted. “This one makes it clear: broken heart syndrome may be more dangerous for men than we thought.”
Experts stress that sudden chest pain or difficulty breathing should always be treated as a medical emergency.
“Don’t try to tough it out or wait it out,” said Bhatt. “Every second counts in protecting your heart from long-term damage.”
While broken heart syndrome is often triggered by sudden events, managing everyday stress through regular exercise, meditation, or therapy may offer additional protection, doctors advise.
“Building resilience through daily stress management gives your body tools to better withstand the unexpected,” said Movahed.