(CNN) – A 59 -year -old man arrived at the first hospital at the Beijing University in Beijing for a procedure when he started to have severe chest pain and shortness of breath.
Four months earlier, he had the cancerous tumors from his bladder withdrawn. Around his family, he did his best to appear and avoided discussions on his health. In private, his severe anxiety about the possibility of a recurrence of cancer maintained him awake at night.
Doctors said that man suffered from Takotsubo cardiomyopathy – also known as broken heart syndrome, as documented in a case study in 2021. Rare heart disease induced by stress was observed mainly in women, but a study published in the Journal of the American Heart Association in May revealed that the disease can be more deadly for men who get it.
Being caused by extreme emotional or physical events – such as learning the death of a loved one, winning the lottery or lifting a heavy sofa – Takotsubo cardiomyopathy, or TC, occurs when the heart muscle is flooded with stress hormones, which has done part of it “does not go”. While the heart has difficulty pumping blood properly, symptoms resemble those of a heart attack, including chest pain, heart palpitations and an irregular heart rate.
The new study analyzed data of nearly 200,000 patients hospitalized for TC in the United States between 2016 and 2020. While women represented 83% of cases, men were more than twice as likely to die of the disease – with a mortality rate of 11.2%.
“The differences between men and women are a very striking observation,” said the co-author of the study, Dr. Mohammad Reza Movahed, professor of clinical medicine at the University of Arizona in Tucson. “It raises an interesting new question that should really be studied.”
Broken heart syndrome in men against women
Similar to the differences between the cardiovascular health of men and women more generally, the differences in mortality rates in TC are not well understood, said Movahed, especially because they thwart other heart disease. It is largely theorized, however, that the differences in hormone levels play a role.
The stressful situations trigger the adrenal glands to release our combat or flight hormones, called catecholamines. They are supposed to increase our blood pressure and increase our heart rate, but extreme levels can temporarily “stun” the cells of the heart tissue, leading to TC, explained Movahed.
Men are believed that men produce more catecholamines in stressful situations compared to women, which may have led men to present more serious cases of TC, he suggested.
Estrogen, a Sex hormone produced at Higher Levels in Women, May also have a protective effect on the cardiovascular system, making it easier to manage an extreme influx of category 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 Study Investigating Discrepancies in Men and Women Who Had Tc. Vincent was not involved in the new study.
Beyond biological differences, social factors can also play a role.
“Most (doctors) know Takotsubo, but they can consider it as a disease that simply affects women, so the diagnosis could be overlooked in men,” said Dr. Deepak Bhatt, cardiologist and director of Mount Sinai Fuster Heart who was not involved in the study. “With an erroneous diagnosis, care is delayed, which can sometimes lead to lower results.”
Men can also request care at a later stage of the disease, believing that their symptoms are manageable or can pass, said Dr. Alejandro Lemor, assistant professor of interventional cardiology at the Mississippi University of Mississippi Center, which was not involved in the study.
The deadly TC complications include blood clots, brain vascular accidents, cardiac arrest and heart failure, Lemor said. If the condition is captured early, drugs can reduce the risk of having these complications, restore an appropriate heart function and allow complete recovery in a few weeks, he added.
Higher mortality rates in men need a more in -depth study
The Movahed team was able to take into account important variables such as age, race, income, chronic pulmonary disease, hypertension and diabetes in the results.
However, there was no data on patients on other comorbid diseases, such as stroke history or the presence of a COVVI-19 infection, said Vincent.
In addition, the new study included hospital diagnostic data only for those hospitalized with TC, so that those who received ambulatory care or died later complications outside the hospital were probably not counted in the analysis, noted Movahed.
To establish a firmer explanation of the differences in mortality rate between men and women and additional test processing methods, a more detailed set of data would be necessary, said Vincent.
“People must be aware in studies like this, we present results based on diagnostic codes, and we do not examine patient procedures or laboratory results,” said Vincent. “But it is powerful in the sense that it allows us to look at large populations and to look at the trends. And I think that this trend of higher mortality in men is worth it to be devoted to a more in -depth look.”
Do not try to “harden”
Sudden and 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 medical school from Mount Sinai to New York.
“Now is not the time to harden at home or put yourself on the internet to understand it. … Do not try to find your primary care provider. Call emergency services,” said Bhatt. “Time counts.
Symptoms according to physical stress factors – A frequent cause of TC in men – should not be ignored, said Movahed, in particular previous medical events such as asthma attacks, convulsions or complications of drug use.
And while TC is caused by sudden stress, Bhatt said that chronic stress management with meditation or daily exercise can lead to better cardiovascular health overall while giving you routines on which fold in unexpected situations.
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