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Published in:

27-12-2023 | Cardiomyopathy

Takotsubo pathophysiology and complications: what we know and what we do not know

Authors: Mehdi Shadmand, Jacob Lautze, Ali Mehdirad MD

Published in: Heart Failure Reviews | Issue 2/2024

Abstract

Takotsubo cardiomyopathy or stress cardiomyopathy (SCM), was first described in 1990 and initially, it was thought to be only associated with short-term complications and mortality with a benign long-term prognosis comparable to a healthy population. However recent investigations have proven otherwise and have shown SCM patients might have comparable long-term morbidity and mortality to ST-elevation myocardial infarction (STEMI) patients. Many emotional, or physical stressors can trigger SCM, and have been able to describe an interplay of neurohormonal and inflammatory mechanisms as the pathophysiology of this disease. Additionally, given the significantly higher prevalence of SCM in post-menopausal women, estrogen levels have been thought to play a role in the pathogenesis of this disease. Furthermore, there is an elusive disparity in prognosis depending upon different triggers. Currently, many questions remain unanswered regarding the long-term management of these patients to reduce morbidity, mortality, and improve quality of life, such as the need for long-term anticoagulation. In this paper, we review the findings of most recent published investigations regarding etiologies, pathophysiology, diagnostic criteria, prognosis, short-term and in more detail, long-term complications of SCM. Finally, we will discuss what future research is needed to learn more about this disease to improve the long-term prognosis, even though as of now, data for long-term management is still lacking.

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Title: Takotsubo pathophysiology and complications: what we know and what we do not know
Authors: Mehdi Shadmand
Jacob Lautze
Ali Mehdirad MD
Publication date: 27-12-2023
Publisher: Springer US
Keywords: Cardiomyopathy
Myocardial Infarction
Acute Coronary Syndrome
Heart Failure
Published in: Heart Failure Reviews / Issue 2/2024
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-023-10381-8

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