Takotsubo syndrome is one of the few heart conditions that have witnessed
an increasing incidence in modern clinical practice. It is an acute syndrome that
presents with various clinical symptoms and etiological factors. Since its first
description in the early 1990s, much progress has been made in many aspects of the
condition including its treatment approaches, clinical investigations, prognosis, clinical
presentation, complications, pathophysiology, epidemiology, triggers, anatomical
variants, primary and secondary clinical subtypes, diagnosis, definition, and
terminology. In addition to clinical studies, many pre-clinical and basic research
platforms and technologies have been developed to help advance our understanding of
this syndrome. This chapter presents a comprehensive discussion on what is the current
state of knowledge concerning this disease. By so doing, we provide the clinical and
non-clinical scientists as well as general readers with new diagnostic approaches, subtypes
classification, and management tools for Takotsubo. New algorithms to facilitate
decision-making by a cardiologist are provided as well as grey areas for further
research.
The sex preference of Takotsubo and the role of estrogen and catecholamines are
brought to focus on providing the future research outlook of this condition. The
available treatments and proposed mechanisms are also summarized. Although
Takotsubo is generally considered to have a good prognosis, some complications of
severe nature may occur in a subset of patients, e.g., dangerous ventricular arrhythmias,
cardiogenic shock, pulmonary edema, which can cause damage to the myocardium
which transcends the recovery phase of the left ventricular ballooning.
Keywords: Acute coronary syndrome, Cardiomyopathies, Catecholamine toxicity,
Cardiac remodeling, Drug-induced cardiomyopathy, Heart failure, Heart
syndromes, Menopausal diseases, Multi-vessel coronary spasm, Microvascular
angina, Pathophysiological mechanisms, Risk stratification, Reversible cardiac syndrome, Stress cardiomyopathy, Stress-induced cardiomyopathy, Takotsubo syndrome,
Takotsubo cardiomyopathy, Variant Angina.
