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Clinical Autonomic Research
Published in: Clinical Autonomic Research 1/2018

Open Access 01-02-2018 | Review

Epidemiology, pathogenesis, and management of takotsubo syndrome

Authors: Shams Y-Hassan, Per Tornvall

Published in: Clinical Autonomic Research | Issue 1/2018

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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.
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Metadata
Title
Epidemiology, pathogenesis, and management of takotsubo syndrome
Authors
Shams Y-Hassan
Per Tornvall
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research / Issue 1/2018
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-017-0465-z

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