Takotsubo syndrome: The past, the present and the future

Abstract

Takotsubo syndrome is a wide spectrum disease with a dramatic clinical presentation mimicking acute coronary syndrome albeit without obstructive coronary disease and typically manifests in the backdrop of intense emotional or physical trigger. Pathophysiology is incompletely understood with multifactorial mechanistic pathways circling around a heart-brain-endocrine axis. Several anatomic and phenotypic variants exist with varied clinical manifestations. The aftermath of Takotsubo syndrome is not always benign and both short- and long-term complications can occur which may impact its prognosis. Several gaps in knowledge exist providing an impetus for tremendous future research opportunities.

Keywords: Takotsubo syndrome; Triggers; Pathophysiology; Anatomic variants; Prognosis

Core tip: Further research is necessary in order to better understand the underlying triggers and pathophysiologic principles of Takotsubo syndrome which will help optimize both in-hospital acute and long-term management pathways.