Presentation of Tako-tsubo Cardiomyopathy in Men and Women

Background: Recent studies have demonstrated that stress-induced Tako-tsubo cardiomyopathy is likely to occur in elderly female patients.

Objectives: The purpose of this study was to evaluate gender differences in the clinical characteristics of patients with Tako-tsubo cardiomyopathy.

Methods: This study consisted of 102 patients with Tako-tsubo cardiomyopathy. It was characterized by akinesia/hypokinesia of the mid-to-distal portion of the left ventricular chamber, with normokinesia/hyperkinesia of the basal portion with an ejection fraction of less than 50% on transthoracic echocardiography.

Results: There were 13 male and 89 female patients. In 10 male patients (77%), Tako-tsubo cardiomyopathy occurred during or immediately after receiving medical treatment or examination for an underlying disease. In 9 male patients (69%), objective symptoms such as abnormality of monitoring or low blood pressure, but not subjective symptoms increased the chance of the patient being diagnosed with Tako-tsubo cardiomyopathy. There was no significant difference in age, body weight, hypertension, or diabetes except for height between male and female patients. The incidence of in-hospital onset was significantly higher in male patients than in female patients (77% vs 17%, P < 0.01). There was no significant difference in in-hospital mortality (15% vs 6%, P = not significant).

Conclusions: These results suggested that physical stress might have more to do with the occurrence of Tako-tsubo in male than female patients.