Abstract
Takotsubo syndrome (TTS) consists of transient dysfunction of the left and/or right ventricle in the absence of ruptured plaque; thrombus or vessel dissection. TTS may be divided into two categories. Primary TTS occurs when the cause of hospitalization is the symptoms resulting from damage to the myocardium usually preceded by emotional stress. Secondary TTS occurs in patients hospitalized for other medical; surgical; anesthetic; obstetric or psychiatric conditions who have activation of their sympathetic nervous system and catecholamines release- they develop TTS as a complication of their primary condition or its treatment. There are several hypotheses concerning the cause of the disease. They include a decrease in estrogen levels; microcirculation dysfunction; endothelial dysfunction and the hypothesis based on the importance of the brain-heart axis. More and more research concerns the importance of genetic factors in the development of the disease. To date; no effective treatment or prevention of recurrent TTS has been found. Only when the pathophysiology of the disease is fully known; then personalized treatment will be possible.
Highlights
Takotsubo syndrome (TTS) is a transient dysfunction of the left and/or right ventricle, without the presence of ruptured atherosclerotic plaque, thrombus, dissection of the artery or other condition, which may cause the aforementioned symptoms
One of the characteristic features of TTS is its association with stress factors triggering the onset of the disease
According to the InterTAK classification, TTS may be classified into three groups based on the type of triggering factor: associated to emotional trigger, physical trigger or with no evident trigger (Table 2) [3]
Summary
Takotsubo syndrome (TTS) is a transient dysfunction of the left and/or right ventricle, without the presence of ruptured atherosclerotic plaque, thrombus, dissection of the artery or other condition, which may cause the aforementioned symptoms. There are multiple clinical scenarios of the course of TTS, which can be classified as either primary—when the primary reason of the hospitalization is symptoms of the acute myocardium injury, mainly triggered with emotional stress, or secondary—the individual is already hospitalized for other medical conditions and as a result of the sudden activation of the sympathetic nervous system (SNS), a rise in catecholamines reversible contractile dysfunction occurs (Table 1). The aim of the article is to review the current literature on typical clinical features and pathophysiology of TTS. The elucidation of the pathophysiology of the disease may be the basis for personalized treatment
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