A blood test that can tell a broken heart from a heart attack
What happened
Researchers at the University of Zurich have developed a scoring system that can tell apart two conditions that look almost identical when someone arrives at hospital: a heart attack, and something called takotsubo syndrome. Their work was published in the European Heart Journal and reported on 1 September 2026. The score is called BioTAK. Takotsubo syndrome is often known as broken heart syndrome. Part of the heart muscle suddenly stops pumping properly, usually after severe emotional or physical stress. It most often affects women who have been through the menopause. The problem for doctors is that it presents just like a heart attack. The chest pain is the same. The ECG can look the same. The blood tests that usually flag heart damage can be raised in both. Yet the causes are completely different, and so is the treatment. The BioTAK score combines five things: four substances measured in the blood, plus the patient's biological sex. The researchers analysed data from more than 3,600 patients who had either acute coronary syndrome or takotsubo syndrome. In a validation group of nearly 1,800 patients, the score correctly sorted almost 90% of them into the right category. Two of the four blood markers are new to this area. One is involved in activating the chemical messengers that regulate the body's stress response. The other relates to the stability of fatty plaques in artery walls. Together they point towards a mechanism running between the brain and the heart, rather than the blocked artery that causes a classic heart attack.
Why this matters
At the moment, the reliable way to tell these two conditions apart is a coronary angiogram. That means threading a thin tube through a blood vessel, usually from the wrist or groin, up to the heart, and injecting dye to look for blockages. It is a routine procedure and generally safe. But it is invasive, it uses radiation and contrast dye, it needs a specialist team, and it carries a small risk of complications. For someone having a genuine heart attack, that is a price well worth paying, because opening a blocked artery quickly saves heart muscle. For someone with takotsubo syndrome, though, there is no blockage to find. The arteries are usually clear. The procedure was necessary to establish that, but the patient has been through an invasive test that did not change what was wrong with them. Takotsubo is not rare enough to ignore. It accounts for roughly 2% of people who initially appear to be having a heart attack, and up to one in ten women presenting with acute coronary syndrome. There is a broader point here too. Women's heart problems have historically been under-recognised, partly because much of the early research on heart disease was done in men. A test built around a condition that mostly affects women, and which explicitly includes sex as part of the calculation, is a small correction to that long imbalance.
What the evidence actually says
This is good research at an early stage. Both halves of that sentence matter. What is strong: the study used data from more than 3,600 patients, which is a substantial number for a condition this uncommon. Crucially, the researchers tested the score on a separate group of nearly 1,800 patients rather than only on the data used to build it. That is the right way to do it. A score that only works on the patients it was designed around is not much use in a real hospital. What needs care: getting it right almost 90% of the time also means getting it wrong in roughly one case in ten. In this particular situation, the cost of the two kinds of error is very different. Wrongly telling someone they have takotsubo when they are actually having a heart attack could delay treatment that saves heart muscle. Wrongly suspecting a heart attack simply means having the angiogram you would have had anyway. That asymmetry is why a score like this is very unlikely to replace angiography outright. It is far more likely to be used to inform the decision, alongside everything else a cardiologist considers. The score has also not yet been tested in routine practice across many hospitals, with the usual pressures of a real emergency department. Research settings tend to produce cleaner results than the real world. This is a normal and necessary next stage, not a criticism. And it is not available. This is published research, not a test you can request. There is nothing here for a patient to ask for at present.
Practical advice
The single most useful thing to take from this story has nothing to do with the new score. It is that chest pain should always be taken seriously, and that heart symptoms in women are still too often dismissed, including by women themselves. Call 999 immediately if you or someone else has chest pain that is severe, lasts more than a few minutes, or comes with sweating, sickness, breathlessness, or pain spreading to the arm, neck, jaw or back. Do not drive yourself. Do not wait to see if it passes. Do not worry about wasting anyone's time. Ambulance crews would far rather attend a false alarm than arrive too late. Know that symptoms can be less dramatic than the films suggest. Some people, and women in particular, experience heart problems as unusual tiredness, indigestion-like discomfort, breathlessness or back pain rather than crushing chest pain. If you have been through severe emotional or physical stress, a bereavement, a serious accident, or major surgery, and you develop chest symptoms, mention that context to the medical team. It is genuinely relevant information. If you have had takotsubo syndrome before, follow up with your cardiology team as advised. Most people recover heart function within weeks to months, but it can recur, and it needs proper follow-up.
What to know
Researchers at the University of Zurich have created the BioTAK score, which uses four blood markers plus a patient's biological sex to distinguish takotsubo syndrome, sometimes called broken heart syndrome, from a genuine heart attack. It was published in the European Heart Journal and reported on 1 September 2026. The two conditions can look almost identical on arrival at hospital, and at present telling them apart reliably requires an invasive coronary angiogram. Takotsubo accounts for around 2% of suspected heart attacks, and up to one in ten women presenting with acute coronary syndrome. In a validation group of nearly 1,800 patients, the score classified almost 90% correctly. That is encouraging. It also means about one in ten were classified wrongly, and because the consequences of the two possible errors are so different, this is likely to become a tool that supports the decision rather than replaces the angiogram. The score is not in clinical use, and it is not something to ask for. What remains true and immediately useful is much simpler: chest pain needs a 999 call, not a wait-and-see. Sources: ScienceDaily, "'Broken heart syndrome' can look just like a heart attack. This test can tell them apart", 1 September 2026, https://www.sciencedaily.com/releases/2026/09/260901070518.htm; EurekAlert / University of Zurich, "UZH researchers develop biomarker score for broken-heart syndrome", https://www.eurekalert.org/news-releases/1141023; European Heart Journal, "Takotsubo syndrome diagnosis: the biomarker-based BioTAK score", https://academic.oup.com/eurheartj/advance-article/8768556 This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you have chest pain or think you may be having a heart attack, call 999 immediately.
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