Psychosocial Stress-Induced Takotsubo Syndrome in a Male Patient: Breaking the Stereotype

Takotsubo syndrome (TTS) predominantly affects postmenopausal women after emotional or physical stress; men account for only ∼10% of cases and are usually triggered by physical precipitants.

A 48-year-old man presented with 24 hours of dyspnea following psychosocial stress related to financial and occupational strain. He was diagnosed with TTS complicated by dynamic left ventricular outflow tract obstruction and 4 discrete apical thrombi identified on cardiac magnetic resonance, and recovered fully with β-blockade and anticoagulation.

This case is doubly atypical in sex and trigger. Severe complications arose despite a lower-risk trigger profile, and cardiac magnetic resonance was essential to detect thrombi and exclude infarction and myocarditis.

Male patients with psychosocial stress-triggered TTS are rare but face significant risk of severe complications, and multimodality imaging including cardiac magnetic resonance is helpful in this underrecognized population.