The Evolving Features of Takotsubo Syndrome

Takotsubo syndrome (TTS) is a transient form of left ventricular dysfunction, typically affecting post-menopausal females, often preceded by emotional or physical stressful events that act as triggers. Initially believed to be a rare and benign condition for its reversible nature, TTS has recently emerged as a complex multifaceted clinical entity, with heterogenous clinical presentations and a non-negligible risk of serious in-hospital complications, including acute heart failure, arrhythmias and death.

Emerging pathophysiological hypotheses, ranging from microvascular dysfunction to systemic inflammation, offer new insights into the underlying mechanisms of TTS. Moreover, increasing awareness of potential complications during the acute phase of the disease underscores its significant prognostic implications and emphasizes the need for randomized clinical trials to guide the therapeutic management of TTS.

In this narrative review article, we aim to discuss the recent insights on the epidemiology, pathophysiology, treatment and prognosis of patients affected by TTS discussing the emerging evidence and the remaining knowledge gap in the field.