Takotsubo Syndrome in Patients With Acute Coronary Syndrome or Myocarditis

Area of Science:

• Cardiology
• Internal Medicine

Background:

• Stress cardiomyopathy/Takotsubo syndrome (TTS) is a transient cardiac condition with reversible left ventricular dysfunction.
• The diagnostic algorithm for TTS typically excludes acute coronary syndrome (ACS) and acute infectious myocarditis.

Purpose of the Study:

• To explore the intricate relationships between TTS and ACS.
• To investigate the association between TTS and myocarditis.
• To delve into the pathophysiologies and diagnostic challenges of these combined conditions.

Main Methods:

• This opinion article reviews existing evidence and proposes a revised diagnostic approach.
• Discussion of pathophysiological mechanisms linking TTS with ACS and myocarditis.
• Analysis of diagnostic challenges in differentiating or co-diagnosing these conditions.

Main Results:

• Recent evidence suggests TTS can occur in patients with ACS, with ACS potentially triggering TTS or vice versa.
• TTS has been reported following confirmed viral myocarditis, indicating a link between infections, myocarditis, and TTS.
• The current diagnostic framework may not adequately capture these complex associations.

Conclusions:

• Further research is essential to elucidate the mechanisms underlying the association between TTS, ACS, and myocarditis.
• A revised diagnostic approach may be needed to include scenarios where TTS co-exists with ACS or myocarditis.
• Understanding these intricate relationships is crucial for accurate diagnosis and management of TTS.