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ARTICLE VIEW:
Why men with broken heart syndrome are more likely to die, according to
experts
By Kameryn Griesser, CNN
Updated:
4:04 PM EDT, Sat June 7, 2025
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Source: CNN
A 59-year-old man arrived at the Peking University First Hospital in
Beijing for a procedure when he started having severe and shortness of
breath.
Four months earlier, he had cancerous tumors removed from his bladder.
Around his family, he tried his best to appear strong and avoided
discussions of his health. Privately, his severe anxiety over the
possibility of a cancer recurrence kept him awake at night.
Doctors said the man was experiencing takotsubo cardiomyopathy — also
known as broken heart syndrome, as documented in a . The rare
stress-induced heart condition has been observed primarily in women,
but a published in the Journal of the American Heart Association in May
found that the illness may be more deadly for the men who get it.
Thought to be caused by extreme emotional or physical events — such
as learning about the death of a loved one, winning the lottery or
lifting a heavy sofa — , or TC, occurs when the heart muscle is
flooded with stress hormones, causing part of it to “freeze” in
place. As the heart struggles to properly pump blood, symptoms resemble
those of a heart attack, including chest pain, heart palpitations and
irregular heartbeat.
The new study analyzed data from nearly 200,000 patients hospitalized
for TC in the United States between 2016 and 2020. While women
accounted for 83% of the cases, men were more than twice as likely to
die from the condition — with a mortality rate of 11.2%.
“The differences between men and women are a very striking
finding,” said study coauthor Dr. Mohammad Reza Movahed, a clinical
professor of medicine at the University of Arizona in Tucson. “It
raises a new, interesting question that should really be studied.”
Broken heart syndrome in men vs.women
Similar to differences between men’s and women’s cardiovascular
health more generally, the discrepancies in TC death rates are not well
understood, Movahed said, especially because they trends in other heart
diseases. It’s widely theorized, however, that differences in hormone
levels play a role.
Stressful situations trigger the adrenal glands to release our
fight-or-flight hormones, called catecholamines. They are meant to
increase our blood pressure and raise our heart rate, but extreme
levels can temporarily “stun” cells in the heart’s tissue,
leading to TC, Movahed explained.
Men are thought to produce more catecholamines during stressful
situations compared with women, possibly leading men to present with
cases of TC, he suggested.
Estrogen, a sex hormone produced at higher levels in women, may also
have a on the cardiovascular system, making it easier to manage an
extreme influx of catecholamines and reducing the risk of severe
complications from TC, said Dr. Louis Vincent, a noninvasive-cardiology
research fellow at the University of Miami, who coauthored a similar,
multiyear investigating discrepancies in men and women who had TC.
Vincent was not involved in the new study.
Beyond biological differences, social factors may play a role as well.
“Most (physicians) know about takotsubo, but they may think of it as
a disease just affecting women, so the diagnosis might be overlooked in
men,” said Dr. Deepak Bhatt, a cardiologist and the director of Mount
Sinai Fuster Heart Hospital who was not involved in the study. “With
misdiagnosis, care is delayed, and that can sometimes lead to worse
outcomes.”
Men may also seek care at a later stage of illness, believing that
their symptoms are manageable or may pass, said Dr. Alejandro Lemor, an
assistant professor of interventional cardiology at the University of
Mississippi Medical Center who was also not involved in the study.
Deadly complications from TC include blood clots, stroke, cardiac
arrest and heart failure, Lemor said. If the condition is caught early,
medications can reduce the risk of having these complications, restore
proper heart function and allow for full recovery within weeks, he
added.
Higher mortality rates in men need further study
Movahed’s team was able to factor for important variables like age,
race, income, chronic lung disease, hypertension and diabetes in the
findings.
However, there was no patient data on other comorbid diseases, such as
a history of stroke or the presence of a Covid-19 infection, Vincent
said.
Additionally, the new study included in-patient diagnostic data only
for those hospitalized with TC, so those who received outpatient care
or died later from complications outside the hospital were likely not
counted in the analysis, Movahed noted.
To establish a firmer explanation for the differences in mortality
rates between men and women and further test treatment methods, a more
detailed dataset would be needed, Vincent said.
“People should be aware in studies like this, we’re presenting
findings that are based on diagnostic codes, and we’re not looking at
patient procedures or lab results,” Vincent said. “But it’s
powerful in the sense that it lets us look at large populations and
look at trends. And I think that this trend of a higher mortality in
men is worth taking a deeper look into.”
Don’t try to ‘tough it out’
Sudden, severe chest pain or shortness of breath should always be
treated as a medical emergency, warned Bhatt, who is also a professor
of cardiovascular medicine at the Icahn School of Medicine at Mount
Sinai in New York City.
“It’s not a time to tough it out at home or get on the internet to
figure it out. … Don’t try to track down your primary care
provider. Call emergency services,” Bhatt said. “Time matters. By
winning those few hours, you could save yourself irreparable damage to
your heart.”
Symptoms following physical stressors — a common cause of TC in men
— should not be ignored, Movahed said, especially preceding medical
events such as asthma attacks, seizures or complications from drug use.
And while TC is caused by sudden stress, Bhatt said that managing
chronic stress with daily meditation or exercise can lead to overall
while giving you routines to fall back on in unexpected situations.
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