This nationwide observational study found a lower incidence of TTS during the pandemic compared to the pre-pandemic period, while mortality rates remained unchanged.
Incidence of Takotsubo syndrome in Sweden was 10% lower during the COVID-19 pandemic than before it.
A total of 3,180 patients were hospitalized with TTS during the study period, with most cases occurring pre-pandemic.
Crude all-cause mortality in the TTS cohort was 2.73% at 30 days and 6.10% at 1 year.
There was no significant difference in 30-day or 1-year mortality between the pandemic and pre-pandemic periods.
The pattern in Sweden (lower TTS incidence) differs from studies in other countries where incidence increased or remained unchanged.
The authors suggest the reduced TTS incidence may reflect Sweden's milder pandemic control measures and more robust social security infrastructure.
Takotsubo syndrome, sometimes called 'broken heart syndrome', is a temporary heart condition often set off by intense emotional or physical stress. Its symptoms resemble a heart attack. Because the COVID-19 pandemic caused major psychological, social and economic stress, researchers wondered whether more people would develop it. Earlier studies from other countries found that cases either rose or stayed about the same, but they were based on one or a few hospitals. This study used Sweden's national coronary angiography registry to compare patients hospitalized with Takotsubo syndrome before the pandemic (January 2015 to March 2020) and during it (April 2020 to December 2022). Of 3,180 patients, 2,189 were pre-pandemic and 991 were during the pandemic. After adjusting for age and sex, the rate of new cases was about 10% lower during the pandemic. Death rates did not differ meaningfully between the periods: about 2.7% of patients died within 30 days and about 6.1% within a year overall. This research suggests that, in Sweden, the pandemic was not linked to a rise in Takotsubo syndrome and that outcomes for patients did not worsen. The authors speculate that Sweden's relatively mild pandemic restrictions and strong social safety net may have played a role, but this was an observational study and cannot prove why the rate was lower. The registry also only captures patients referred for coronary angiography, so it may not include every case.
Gudmundsson T, Petursson P, Råmunddal T, Angeras O, Rawshani A, Frobert O, et al.. (2026). Impact of the COVID-19 pandemic on the incidence and mortality of Takotsubo syndrome in Sweden, a report from the SWEDEHEART registry.. BMC cardiovascular disorders. https://doi.org/10.1186/s12872-026-06889-0