Takotsubo Syndrome: An Historical Perspective

For the past 25 years there has been an accelerating stream of literature reports on a pathological entity, called Takotsubo syndrome (TTS) (2,882 items in Pubmed, in response to the MeSH term “takotsubo”, as of 4/5/16),1 a term coined by Sato et al,2 and Dote and al,3 when they described in 1990 and 1991 respectively a transient left ventricular (LV) dysfunctional state, which make the angiographic silhouette of the LV in systole of the involved patients to resemble “takotsubo”, a wide based, narrow necked Japanese fishing tool used to capture octopuses. These authors attributed TTS to a diffuse coronary vasospasm, since the emerging clinical picture appeared to be of ischemic nature, and the coronary arteries were not occluded, or severely stenotic.2,3 Although the pathophysiology of TTS remains to date elusive, the overwhelming support from the literature1 suggests that coronary vasospasm is not at the roots of TTS, although it could be a contributor, if a multi-factorial etiological underpinning is assumed.4 The original descriptions of TTS are inaccessible to the Western physicians, since they are written in Japanese,2,3 but after a hiatus of 10 years from those reports, the first article written in English, listed in Pubmed, appeared in 2000, which ushered in the avalanche of accelerating reporting on TTS we are currently experiencing.1