Takotsubo Syndrome, a challenging disease: a brief review

Abstract

Introduction: Takotsubo Syndrome (TTS) is characterized by acute transient left ventricular systolic dysfunction. Despite TTS has been described 30 years ago, its pathogenesis and pathophysiology remain poorly understood and the true prevalence remains uncertain because of its under-recognition.

Evidence acquisition: To provide an update on the current understanding of the clinical features of Takotsubo Syndrome, we searched the PubMed databases by using the medical subject headings Takotsubo Syndrome. Exclusion criteria included case reports, conference abstracts, non-English literature and unrelated studies.

Evidence synthesis: Patients with TTS classically present with acute-onset chest pain, dyspnea, and changes on the ECG occurring in association with an acute stressful event. This presentation mimicking other causes of acute myocardial injury often represents a clinical dilemma; moreover, the lack of evidence-based interventions to treat the acute episode, to prevent major adverse cardiovascular events and to avoid recurrences represents a difficult challenge for the physicians.

Conclusions: At present TTS remains a poorly understood condition with substantial morbidity and mortality and without robust evidence or clinical trials available for the management that need to be addressed. The purpose of this review is to provide an update on the current understanding of the clinical features of this condition, to discuss the latest theories regarding its etiology and pathophysiology, and to highlight the need for future therapeutic interventions.