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Y-Hassan S, Tornvall P. Epidemiology, pathogenesis, and management of takotsubo syndrome. Clin Auton Res. 2017;28(1):53-65doi: 10.1007/s10286-017-0465-z.
Y-Hassan, S., & Tornvall, P. (2018). Epidemiology, pathogenesis, and management of takotsubo syndrome. Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 28(1), 53-65. https://doi.org/10.1007/s10286-017-0465-z
Y-Hassan, Shams, and Tornvall, Per. "Epidemiology, pathogenesis, and management of takotsubo syndrome." Clinical autonomic research : official journal of the Clinical Autonomic Research Society vol. 28,1 (2018): 53-65. doi: https://doi.org/10.1007/s10286-017-0465-z
Y-Hassan S, Tornvall P. Epidemiology, pathogenesis, and management of takotsubo syndrome. Clin Auton Res. 2018 Feb;28(1):53-65. doi: 10.1007/s10286-017-0465-z. Epub 2017 Sep 15. PMID: 28917022; PMCID: PMC5805795.
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Clin Auton Res. 2018 Feb;28(1):53-65. doi: 10.1007/s10286-017-0465-z. Epub 2017 Sep 15.

Epidemiology, pathogenesis, and management of takotsubo syndrome.

Clinical autonomic research : official journal of the Clinical Autonomic Research Society

Shams Y-Hassan, Per Tornvall

Affiliations

  1. Department of Cardiology, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden.
  2. Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden. [email protected].

PMID: 28917022 PMCID: PMC5805795 DOI: 10.1007/s10286-017-0465-z

Abstract

Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Patients with predisposing factors such as malignancy and other chronic comorbidities are more prone to suffer from takotsubo syndrome. The pathogenesis of takotsubo syndrome is elusive. Several pathophysiological mechanisms involving myocardial ischemia (multivessel coronary artery spasm, microvascular dysfunction, aborted myocardial infarction), left ventricular outlet tract obstruction, blood-borne catecholamine myocardial toxicity, epinephrine-induced switch in signal trafficking, and autonomic nervous system dysfunction have been proposed. The syndrome is usually reversible; nevertheless, during the acute stage, a substantial number of patients develop severe complications such as arrhythmias, heart failure including pulmonary edema and cardiogenic shock, thromboembolism, cardiac arrest, and rupture. Treatment of precipitating factors, predisposing diseases, and complications is fundamental during the acute stage of the disease. The epidemiology, pathogenesis, and management of takotsubo syndrome are reviewed in this paper.

Keywords: Acute coronary syndrome; Broken heart syndrome; Left ventricle ballooning; Neurogenic stunned myocardium; Takotsubo

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