Takotsubo Syndrome and Cancer: Pathophysiological Links and Clinical Perspectives

Takotsubo syndrome (TTS) is an acute, reversible cardiomyopathy that clinically mimics acute coronary syndrome in the absence of obstructive coronary artery disease. In oncology, TTS may be precipitated by the cancer milieu itself (stress, inflammation, neuroendocrine activation) and by antineoplastic therapies, notably fluoropyrimidines, vascular endothelial growth factor (VEGF) pathway inhibitors, tyrosine kinase inhibitors, and immune checkpoint inhibitors. Cancer currently stands as the second leading cause of morbidity and mortality worldwide. Cancer can directly induce TTS through an increase in catecholamines or indirectly via surgical and chemotherapeutic treatments. Several antineoplastic drugs are associated with an increased risk of TTS. We conducted a narrative, clinically oriented review. This narrative review aims to analyze the pathophysiological link between TTS and cancer and to explore potential preventive and therapeutic strategies in cancer patients.