Takotsubo Cardiomyopathy in Men: Different Face, Same Disease

Abstract

Background: Takotsubo cardiomyopathy (TCM) or stress-induced cardiomyopathy is a relatively new entity in the western world characterized by reversible left ventricular dysfunction in response to an acute severe emotional or physical stressor. Most commonly, it presents in postmenopausal women with only rare reports in men. Little is known of the characteristics of the male population who suffer from this condition. Objective: To describe the common characteristics of TCM in males. Methods: We conducted a systematic literature review using a MEDLINE database search for English language publications that included the search terms ‘takotsubo’, ‘apical ballooning syndrome’ and ‘stress cardiomyopathy’. Articles describing male patients with their demographic and clinical presentation were included in the study. Results: From the literature review, 719 publications were queried from which we were able to identify 110 male patients. Mean patient age was 59 ± 4 years. Male patients had a high prevalence of underlying malignancies (33%), and medical/surgical procedures or physical stress (51%). The initial symptoms and disease manifestation occurred in the hospital setting in a majority of cases (73%). Conclusion: TCM uncommonly occurs in men. When it does, subjects tend to be younger and have a high incidence of malignancies, and physical or peri-procedural stress. Further, TCM in men presents most commonly during the inpatient hospital setting. Background: Takotsubo cardiomyopathy (TCM) or stress-induced cardiomyopathy is a relatively new entity in the western world characterized by reversible left ventricular dysfunction in response to an acute severe emotional or physical stressor. Most commonly, it presents in postmenopausal women with only rare reports in men. Little is known of the characteristics of the male population who suffer from this condition. Objective: To describe the common characteristics of TCM in males. Methods: We conducted a systematic literature review using a MEDLINE database search for English language publications that included the search terms ‘takotsubo’, ‘apical ballooning syndrome’ and ‘stress cardiomyopathy’. Articles describing male patients with their demographic and clinical presentation were included in the study. Results: From the literature review, 719 publications were queried from which we were able to identify 110 male patients. Mean patient age was 59 ± 4 years. Male patients had a high prevalence of underlying malignancies (33%), and medical/surgical procedures or physical stress (51%). The initial symptoms and disease manifestation occurred in the hospital setting in a majority of cases (73%). Conclusion: TCM uncommonly occurs in men. When it does, subjects tend to be younger and have a high incidence of malignancies, and physical or peri-procedural stress. Further, TCM in men presents most commonly during the inpatient hospital setting.