Clinical Characteristics and Outcomes of Recurrent Takotsubo Syndrome Patients in Auckland, New Zealand

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Recurrent Takotsubo syndrome (TS) is not uncommon, but experience with TS recurrence is inherently limited by the infrequency of the condition itself and incomplete long-term follow-up. There are limited published data on the clinical features and outcomes of patients with recurrent TS. This study aimed to describe the clinical characteristics and outcomes of patients with recurrent TS in a large Auckland cohort. The clinical profile, in-hospital, and long-term outcomes were prospectively assessed in consecutive patients with recurrent TS presenting to Auckland’s three major hospitals between January 2006 and January 2023. A total of 478 patients presented with TS during the study period. Of the 473 patients discharged alive after the index event, 45 (9.5%) patients, all women, experienced recurrent TS, none of which was fatal. Three of these patients experienced two recurrences, and one experienced three recurrences. The mean age at first recurrence was 65.7±10.8 years. Time from index event to the first recurrence ranged 27 days–5,044 days. In 27 (60%) of the 45 patients with TS recurrence, the subsequent events involved stress triggers (physical triggers, n=8; emotional triggers, n=19). Eighteen (40%) of 45 patients had a change in stressor type at first recurrence (Figure 1). Thirteen (28.9%) had a different wall motion pattern at first recurrence (Figure 2). Recurrent TS is not uncommon. Both the stressor types and the ventricular wall motion pattern may differ during recurrent events.Figure 1View Large Image Figure ViewerDownload Hi-res image Download (PPT)