Misconceptions and Facts About Takotsubo Syndrome

Am J Med. 2019 Jan;132(1):25-31. doi: 10.1016/j.amjmed.2018.07.007. Epub 2018 Aug 3.

Abstract

Takotsubo syndrome, initially described in the 1990s by Sato, has been increasingly recognized around the world. Pathophysiology is directed towards central role of catecholamine surge , but other aspects like microvascular endothelial dysfunction and vasospasm have also been described. Dyspnea and chest pain are most common manifestations, but syncope can also be seen. Right ventricular involvement is not uncommon, and left ventricular outflow tract obstruction is a frequent complication. EKG can differentiate between Takotsubo syndrome and myocardial infarction, but coronary angiography should always be performed. Although treatment has been angiotensin converting enzyme inhibitors and betablockers, recent evidence from nonrandomized studies shows no benefit on betablockers regarding outcomes.

Keywords: Acute heart failure; Apical ballooning; Takotsubo.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Biomarkers
  • Catecholamines / blood
  • Electrocardiography
  • Humans
  • Myocardial Infarction / diagnosis
  • Prognosis
  • Recurrence
  • Takotsubo Cardiomyopathy / blood
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / drug therapy
  • Takotsubo Cardiomyopathy / etiology*

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Biomarkers
  • Catecholamines