Takotsubo Cardiomyopathy: Narrative Review With Relation to COVID-19

Abstract

Takotsubo cardiomyopathy (TC) is a unique heart disease which mimics the clinical symptoms and features of acute coronary syndrome (ACS) and is seen more commonly in postmenopausal females. In this condition, abnormal electrocardiographic findings like ST-segment elevation/depression, T wave inversion, and an abnormal/absence of Q wave, along with echocardiographic disturbances like regional wall motion abnormalities and a sudden decrease in the ejection fraction are observed. However, coronary angiography shows no coronary artery obstruction. Interestingly, the left ventricle in TC develops a characteristic appearance similar to that of a “Tako-tsubo” (Japanese pot). Such peculiar observations become important when diagnosing TC in a clinical setting. TC is often caused by a catecholamine surge due to mass sympathetic activation usually preceded by an emotional/physical trigger, however the exact etiology and mechanism of pathophysiology still remain unclear. With growing awareness and prevalence of TC, it becomes crucial for clinicians to differentially diagnose TC from other heart conditions with the help of well-known diagnostic tools. Moreover, amidst the ongoing pandemic, the cytokine storm associated with COVID-19 may be accompanied with a catecholamine surge in the body, which in turn might increase the risk and incidence of TC in patients.