Secondary Takotsubo Syndrome: An Updated Literature Review and Case Report

Takotsubo syndrome (TTS), also commonly referred to as “stress cardiomyopathy”, “transient left ventricular apical ballooning syndrome”, “neurogenic stunned myocardium”, “broken heart syndrome” or “ampulla-shaped cardiomyopathy”, has steadily increased in prevalence since its primary identification circa 32 years ago (Sato, et al., 2020). This rare condition is characterised by an apical myocardial contractile dysfunction, without the presence of coronary artery obstruction (Prokudina et al., 2020). Despite increasing awareness among researchers and medical professionals, the precise mechanisms governing the pathophysiology of this disease are somewhat unclear (Lyon et al., 2008). Nevertheless, the association between TTS and a preceding immense, stressful trigger has been long-established (Wittstein et al., 2005). Similarly, recent evidence has shown that the connection between the heart and the nervous system plays a role in the development of this disease (Klein et al., 2017; Silva et al., 2019; Templin et al., 2019; X. Wang et al., 2020). This article presents an updated literature review on TTS with an emphasis on secondary TSS, followed by a case report on the presentation, investigation and management of an 87 year old Caucasian male with secondary TTS, occurring in the setting of a post-mechanical fall, and a right basi-cervical hip fracture. His secondary TTS is also believed to have been precipitated by the patient receiving the news of the passing away of his wife.