A score built from a handful of blood values can separate Takotsubo syndrome from a heart attack before a cardiac catheter is inserted.

The so-called BioTAK score was developed by an international team. Specialists from the University of Zurich and University Medical Center Greifswald took part. The work appeared in the European Heart Journal at the end of August 2026. In an independent validation involving nearly 1,800 patients, the score classified almost 90 percent of cases correctly. MDR Wissen and the science service Medical Xpress report on the findings.

For patients, an invasive procedure is at stake. Takotsubo syndrome is an acute disturbance of the heart's pumping function. It is usually triggered by severe emotional or physical stress. Postmenopausal women are affected above all. The complaints resemble a heart attack: chest pain, changes in the electrocardiogram, raised cardiac enzymes. The coronary arteries, however, are not blocked. Anyone wanting to tell the two conditions apart reliably has so far needed the catheter. For a share of those examined, it brings no benefit.

The frequencies show how large that share is. Around two percent of all people with a suspected heart attack have Takotsubo syndrome. Among women with acute coronary syndrome, MDR reports, it affects up to one in ten.

Two new markers

The score combines biological sex with several protein markers in the blood. The team used artificial intelligence to work out which combination carries the most information. Two of the markers are new in this role. One protein activates messenger substances that govern stress responses, anxiety, vascular tone and unconscious bodily functions. The second is linked to the stability of deposits in the arteries. Together they point to an axis between brain and heart. The mechanism apparently operates independently of arterial calcification.

"Our study shows that a simple combination of blood biomarkers and biological sex can identify these patients with remarkable accuracy even before cardiac catheterization," says Florian A. Wenzl of the Center for Molecular Cardiology at the University of Zurich, one of the study's co-first authors.

The test does not replace the catheter. Christian Templin heads the Department of Internal Medicine B at University Medical Center Greifswald and founded the international Takotsubo registry. "The BioTAK score is not a substitute for cardiac catheterization when it is medically necessary. However, it could help guide diagnostic procedures more effectively and avoid unnecessary invasive tests in selected patients," he says.

Whether the score actually spares patients procedures in everyday hospital practice remains open. Further studies are meant to settle that.