A Current Overview of Takotsubo Syndrome

Takotsubo syndrome is an acute, reversible disease characterized by transient dysfunction of the left ventricle of the heart. The pathogenesis of Takotsubo syndrome is not known precisely. However, various hypotheses regarding pathogenesis have been put forward. These hypotheses; coronary microvascular dysfunction, coronary artery spasm, catecholamine-induced myocardial stunning, reperfusion injury after acute coronary syndrome, myocardial microinfarction, endothelial dysfunction and estrogen deficiency, and abnormalities in cardiac fatty acid metabolism. Among these hypotheses and theories, catecholamine-induced cardiotoxicity and coronary microvascular dysfunction are most frequently emphasized. Takotsubo syndrome manifests itself with some clinical symptoms and signs. In Takotsubo syndrome, symptoms seen at presentation are chest pain, shortness of breath, and syncope, from the most common to the least. Clinically, it can be confused with acute myocardial infarction or acute coronary syndrome because it causes complaints such as acute chest pain and shortness of breath. Therefore, it is important to differentiate from these diseases. Anamnesis, physical examination, cardiac troponin, creatine kinase, troponin, electrocardiography (ECG), coronary angiography are used in the differential diagnosis. The presence of physical or emotional stress plays an important role in the differential diagnosis of Takotsubo syndrome. There is no specific treatment for Takotsubo syndrome. However, treatment can be divided into two parts as acute and chronic phases. While treatments for complications arising due to Takotsubo syndrome are applied in the acute phase, drugs such as beta blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers are used in the chronic phase. Takotsubo syndrome can also be seen in intensive care patients. In intensive care patients, it often manifests itself with hemodynamic disturbances and respiratory failure. Therefore, Takotsubo syndrome should be considered in intensive care patients when hemodynamic and respiratory changes are observed and patients should be followed up in this direction.