Takotsubo syndrome (TTS), a dangerous condition that can weaken heart muscle, has seen a steady increase among Americans, especially older women, a new study reveals.

Commonly called broken heart syndrome, or sometimes stress cardiomyopathy, the condition is thought to be caused by surges of stress hormones and can happen in otherwise healthy people. Symptoms and test results are similar to those seen in cardiac arrest, but with no sign of blocked arteries, according to the American Heart Association. The condition can cause sudden chest pain and short-term heart muscle damage.

To improve the understanding of how prevalent the condition is in Americans, investigators looked at age‐ and sex‐based trends in TTS incidence, using hospital inpatient data from 2006 to 2017. 

They found more than 135, 000 cases of TTS that increased annually for both men and women. Women accounted for 88% of the cases — particularly those aged 50 years and older.

There was a notably greater increase in TTS incidence among middle‐aged and older women when compared with their younger counterparts. The increase in cases per million per year in middle age were 128 cases in middle-aged women, 96 cases in older women, and 28 cases in younger women, the researchers reported. The most prominent at‐risk group was women aged 50 to 74 years.

Middle-aged men also had significantly greater increases in annual cases than younger men, but the same was not sure among older men.

There are a number of factors that may be contributing to these apparent upticks in TTS, beyond increased recognition, advanced diagnostics, and better documentation, wrote senior author Susan Cheng, M.D., of the Cedars‐Sinai Medical Center, Los Angeles. But the steep increases in middle-aged to older women overall doesn’t appear to be completely explained by improvements in clinical recognition, she said. 

Additional factors may include:

  • The increasing size of the at‐risk population, including aging adults and aging women in particular;
  • Changes in socioeconomic and environmental stressors that may be particularly relevant to susceptible middle‐aged and particularly older‐aged individuals; and
  • The potential evolution in the nature of TTS as a disease entity, which is known to have various causes and presentations.

The study was published in the Journal of the American Heart Association.