Takotsubo syndrome: From pathophysiology to clinical practice

Area of Science:

• Cardiology
• Cardiovascular Research
• Neurocardiology

Background:

• Takotsubo syndrome (TTS) presents acutely with left ventricular dysfunction, mimicking myocardial infarction but lacking obstructive coronary artery disease.
• Pathophysiology involves sympathetic hyperactivation, catecholamine surge, and brain-heart axis imbalance.
• Previously underestimated, TTS is now recognized for significant adverse events and mortality comparable to acute coronary syndromes.

Purpose of the Study:

• To provide a comprehensive synthesis of current knowledge on Takotsubo syndrome.
• To review epidemiology, pathophysiology, diagnostics, complications, and management.
• To identify evidence gaps for future clinical trials.

Main Methods:

• Literature review and synthesis of existing studies on Takotsubo syndrome.
• Analysis of diagnostic criteria including clinical assessment, biomarkers, ECG, and advanced imaging (echocardiography, cardiac MRI).
• Evaluation of management strategies based on hemodynamic phenotypes.

Main Results:

• TTS shares clinical presentation with myocardial infarction but has unique pathophysiological drivers.
• Adverse events include cardiogenic shock, arrhythmias, and thromboembolism.
• Mortality rates are comparable to acute coronary syndromes.

Conclusions:

• Takotsubo syndrome requires integrated diagnostic approaches.
• Management is supportive and phenotype-dependent.
• Further clinical trials are needed to address evidence gaps.