Why Broken Heart Syndrome Is Deadlier for Men—And Too Often Overlooked

Sunday, June 8, 2025.

It started like a routine hospital visit. A 59-year-old man walked into a Beijing clinic for a standard medical procedure.

But then—sharp chest pain. Gasping for air. His heart, it seemed, was under siege.

What followed wasn’t a typical heart attack. Doctors diagnosed him with takotsubo cardiomyopathy—a condition so closely tied to emotional pain that it's often called broken heart syndrome.

For months, this man had quietly carried the heavy weight of fear and anxiety following cancer surgery, never letting his family see just how frightened he was.

That silent stress—unspoken and unresolved—may have played a role in stopping his heart.

And he’s not alone.

When the Heart Breaks for Real

Takotsubo cardiomyopathy (TC) is a sudden, stress-induced heart condition that mimics the symptoms of a heart attack.

Chest pain. Palpitations. Breathlessness.

But unlike a heart attack, there's no blocked artery—just a surge of stress hormones that stuns the heart into dysfunction.

It’s named after a Japanese octopus trap because of the shape the left ventricle takes on during an episode: ballooned, strained, barely pumping.

It’s long been seen as something that mostly affects women—especially after emotional events like the loss of a loved one.

But a recent study published in The Journal of the American Heart Association found something more troubling: men who develop broken heart syndrome are more than twice as likely to die from it as women.

Why Are Men at Higher Risk?

In a dataset of nearly 200,000 hospital patients treated for TC between 2016 and 2020, women made up the vast majority—about 83%. But the men who did suffer from it were far more likely to die, with a mortality rate of 11.2%.

According to Dr. Mohammad Reza Movahed, one of the study’s authors, this gender gap in outcomes is a red flag we can’t ignore. While the reasons aren’t entirely clear, several key factors stand out:

Biology and Hormones

Stress floods the body with fight-or-flight hormones—catecholamines like adrenaline and norepinephrine. In high doses, these chemicals can “stun” the heart, leaving it unable to pump effectively.

Men tend to produce higher levels of catecholamines during extreme stress than women, which may mean they experience more severe forms of the condition.

Meanwhile, estrogen, more abundant in women, may help buffer the heart from the worst of the damage. It’s protective, in ways we’re only beginning to understand.

Delaying Care

Many men wait too long to seek help. They brush off chest pain as indigestion. They assume the tightness in their chest will go away. By the time they seek treatment, the condition has often progressed dangerously.

“There’s this cultural expectation that men should tough things out,” said Dr. Alejandro Lemor, an interventional cardiologist. “But in this case, that delay can be deadly.”

Misdiagnosis

Because TC has been seen as a “women’s disease,” doctors may be slower to diagnose it in men. That can lead to precious hours lost—hours that matter when the heart is struggling to function.

Silent Suffering, Serious Risks

The most common triggers for TC in men aren’t always emotional breakups or grief.

They’re often physical stressors—a surgery, a seizure, a bad reaction to medication, or complications from substance use. And yet, the emotional strain that follows these events—fear, anxiety, the effort to appear “strong”—can be just as intense.

Left untreated, takotsubo cardiomyopathy can lead to blood clots, stroke, heart failure, and even death. But the good news is: it’s reversible. With early intervention—rest, medication, and proper follow-up—most patients recover completely within weeks.

What You Can Do (Or Say to Someone You Love)

• Don’t ignore chest pain or shortness of breath. If it’s sudden and severe, call emergency services. Don’t wait.

• Talk about what you're going through. Emotional suppression doesn't make you strong—it makes you sick.

• Learn how your body holds stress. Meditation, movement, breathwork, and therapy aren't luxuries. They're tools of survival.

• Ask your doctor about TC if your symptoms don’t fit a “normal” heart attack.

A Culture of Quiet Pain

What this new research makes heartbreakingly clear is that emotional pain doesn’t just hurt—it can kill. And when it comes to men, it’s often cloaked in silence.

The man in Beijing tried to spare his loved ones by swallowing his fear.

But what if his heart had been allowed to break, aloud? What if our culture gave men room to grieve, fear, and feel—without shame?

Because maybe broken heart syndrome isn’t just about biology. Maybe it’s also about the consequences of pretending everything is fine.

If you or someone you love is pushing through emotional pain with gritted teeth and a brave face, take this as a sign: you’re allowed to hurt. And you’re allowed to heal. Don’t wait until the body screams what the soul has been whispering all along.

Be Well, Stay Kind, and Godspeed.

REFERENCES:

Movahed, M. R., Hashemzadeh, M., Donohue, D., & Jamal, M. M. (2024). Gender-based differences in outcomes of Takotsubo Cardiomyopathy: A national database analysis. Journal of the American Heart Association, 13(5), e031452. https://doi.org/10.1161/JAHA.124.031452

Vincent, L., & Awan, M. U. (2023). Estrogen and cardiac protection in Takotsubo cardiomyopathy: A systematic review. Cardiology in Review, 31(1), 1–7.

Bhatt, D. L. (2022). Recognizing Takotsubo in men: When stress breaks the heart. The Lancet Regional Health – Americas, 8, 100237.

Lemor, A., et al. (2023). Delay in care and complications in men with Takotsubo syndrome: A clinical perspective. American Journal of Cardiology, 191, 56–62.