Why men are more likely to die from Takotsubo
Key Takeaways
Industry Buzz
“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. With misdiagnosis, care is delayed, and that can sometimes lead to worse outcomes.” — Deepak Bhatt, MD, cardiologist and director of Mount Sinai Fuster Heart Hospital
Imagine a 59‑year‑old man who’s just had cancer surgery. He’s holding it together—on the outside. But internally? He’s spiraling with anxiety about recurrence. Then he develops acute chest pain and shortness of breath during a minor hospital procedure.
Somewhat surprisingly, his tests show Takotsubo cardiomyopathy (stress‑induced heart dysfunction), not a classic heart attack.
What’s particularly concerning is that while Takotsubo cardiomyopathy (TC)—aka “broken heart syndrome”—hits women most often, when men get it, their risk of dying is sky‑high. Consider the following findings from a US in‑hospital study of nearly 200,000 cases from 2016–2020:[]
Overall mortality: 6.5%
Women: 5.5%
Men: 11.2% (more than double that of women)
However, this analysis relied on diagnostic codes—not detailed clinical or procedural data—so we don’t know precise triggers or downstream outpatient outcomes.
Related: Yes, a bad breakup actually can break your heartWhy are men at unique risk?
1. Catecholamine surge: Men may produce more adrenaline and noradrenaline in response to acute stress. Extremely high levels can temporarily “stun” cells in the heart’s tissue, leading to TC. []
2. Hormonal defense: Estrogen could offer some protection against catecholamine toxicity. Post‑menopausal women may be less sheltered, but men start without this hormonal buffer. []
3. Delay in diagnosis: TC is often labeled a “female disease,” so physicians may not immediately suspect it in men. That can delay treatment. []
4. Underreporting by patients: Men may downplay symptoms or avoid seeking help, attributing chest discomfort to less serious causes. []
“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 Deepak Bhatt, MD, a cardiologist, in a recent CNN interview. “With misdiagnosis, care is delayed, and that can sometimes lead to worse outcomes.” []
Why early detection matters
Complications from TC are common—and deadly:
Congestive heart failure (~36%)
Atrial fibrillation (~21%)
Cardiogenic shock (~6.6%)
Stroke (~5.3%)
Cardiac arrest (~3.4%) []
If TC is identified promptly and managed with supportive care—ACE inhibitors, beta-blockers, aspirin, diuretics—ventricular function may recover within weeks. Untreated, however, complications can escalate quickly.