New analysis urges routine screening for anxiety, depression and trauma symptoms after MINOCA and “broken‑heart” syndrome.
A systematic review in the European Journal of Preventive Cardiology reports that people who survive a heart attack without blocked arteries—known as MINOCA—or the stress‑induced “broken‑heart” condition called takotsubo syndrome (TS) frequently experience poorer mental health and quality of life than healthy peers, and at least as often as patients recovering from typical, obstructive heart attacks.
Why this matters
MINOCA accounts for roughly 5–6% of all heart attacks, while TS represents 2–3% of emergency presentations for suspected acute coronary syndrome. Compared with classic heart attacks, these conditions disproportionately affect women, occur at younger ages, and are linked with a history of psychological distress—factors that make mental‑health follow‑up especially important.
What the researchers did
The team reviewed 28 studies (sample sizes ranged from 13 to 5,322 people) that tracked anxiety, depression, post‑traumatic stress and/or quality of life after MINOCA or TS. The review was preregistered and followed PRISMA standards. Most studies were small and observational; 18 of the 28 were judged at high risk of bias, underlining the need for stronger research.
What they found
Across studies, people with MINOCA or TS commonly reported worse mental health and quality of life than healthy controls—and as often or more often than other cardiac patients. That message is highlighted in the paper’s lay summary and graphical abstract.
The trajectory over time varies: several studies noted stress and depressive symptoms easing between the first weeks and 3–6 months after the event, with improvements that sometimes persisted to one year; however, at one year, TS survivors in one study still reported lower emotional well‑being and a higher prevalence of depression than comparison groups.
Who is most affected?
Women make up a large share of MINOCA and especially TS cohorts (many samples were majority female), reinforcing the need for gender‑sensitive cardiac rehab and mental‑health care.
Caveats
Because most studies were observational and many were small, the review cannot prove cause‑and‑effect or identify one best treatment plan. The authors call for larger, higher‑quality trials that build mental‑health outcomes into cardiac care for these patients. (The risk‑of‑bias charts in the paper’s figures make this gap clear.)
What patients and families can do now
- Ask for screening for anxiety, depression, and post‑traumatic stress during follow‑up visits—especially in the first weeks to months after discharge.
- Enroll in cardiac rehabilitation and request programs that include psychological support or counseling.
- Watch for warning signs—persistent low mood, intrusive memories, sleep problems, or loss of interest—and share them with your care team.
- Include caregivers: family members can help track symptoms and encourage follow‑up.
Bottom line
After MINOCA or takotsubo syndrome, mental health is a key part of recovery. Screening and support should be routine, not optional—while researchers work to close the evidence gaps.
Source: Leissner P, Olsson EMG, Rondung E, et al. “Mental health status and quality of life after an acute myocardial infarction with non‑obstructive coronary arteries or takotsubo syndrome: a systematic review,” European Journal of Preventive Cardiology*, 2025.*
Editor’s note: This article is for information only and is not a substitute for professional medical advice.