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. 2018 Jun 7;39(22):2032-2046.
doi: 10.1093/eurheartj/ehy076.

International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology

Jelena-Rima Ghadri  1 , Ilan Shor Wittstein  2 , Abhiram Prasad  3 , Scott Sharkey  4 , Keigo Dote  5 , Yoshihiro John Akashi  6 , Victoria Lucia Cammann  1 , Filippo Crea  7 , Leonarda Galiuto  7 , Walter Desmet  8   9 , Tetsuro Yoshida  10 , Roberto Manfredini  11 , Ingo Eitel  12 , Masami Kosuge  13 , Holger M Nef  14 , Abhishek Deshmukh  3 , Amir Lerman  3 , Eduardo Bossone  15 , Rodolfo Citro  15 , Takashi Ueyama  16 , Domenico Corrado  17 , Satoshi Kurisu  18 , Frank Ruschitzka  1 , David Winchester  19 , Alexander R Lyon  20   21 , Elmir Omerovic  22   23 , Jeroen J Bax  24 , Patrick Meimoun  25 , Guiseppe Tarantini  17 , Charanjit Rihal  3 , Shams Y-Hassan  26 , Federico Migliore  17 , John D Horowitz  27 , Hiroaki Shimokawa  28 , Thomas Felix Lüscher  29   30 , Christian Templin  1
Affiliations

International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology

Jelena-Rima Ghadri et al. Eur Heart J. .

Abstract

Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated with severe clinical complications including death and that its prevalence is probably underestimated. Since current guidelines on TTS are lacking, it appears timely and important to provide an expert consensus statement on TTS. The clinical expert consensus document part I summarizes the current state of knowledge on clinical presentation and characteristics of TTS and agrees on controversies surrounding TTS such as nomenclature, different TTS types, role of coronary artery disease, and etiology. This consensus also proposes new diagnostic criteria based on current knowledge to improve diagnostic accuracy.

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Figures

Figure 1
Figure 1
Historical Japanese octopus trap (left). Courtesy of Dr Templin, University Hospital Zurich, Zurich, Switzerland. Left ventriculogram of the first reported case of takotsubo syndrome. Diastole (A) and systole (B) during the acute phase of takotsubo syndrome. Recovery of left ventricular wall motion abnormality two weeks after the event (C and D). Courtesy of Dr Dote, Hiroshima City Asa Hospital, Hiroshima, Japan.
Figure 2
Figure 2
Age and sex distribution of patients with takotsubo syndrome. Reprinted with permission from Templin et al.
Figure 3
Figure 3
Emotional and physical stress factors precipitating takotsubo syndrome. Reprinted, modified, and translated with permission from Schlossbauer et al. COPD, chronic obstructive pulmonary disease; PRES, posterior reversible encephalopathy syndrome; TIA, transient ischaemic attack.
Figure 4
Figure 4
The four different types of takotsubo syndrome during diastole (left column) and systole (middle column). The right column depicts diastole in red and systole in white. The blue dashed lines demonstrate the region of the wall motion abnormality. Reprinted and modified with permission from Templin et al.
See this image and copyright information in PMC

Comment in

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