Key result
Takotsubo syndrome management remains largely empirical and relies on expert consensus without randomized trials.
Why the study?
Evidence-based management strategies for Takotsubo syndrome remain limited due to the absence of randomized controlled trials despite its recognized complicated clinical course.
Current management of Takotsubo syndrome lacks robust randomized trial evidence and relies on empirical, multidisciplinary approaches integrating cardiovascular, neurological, and psychological care.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We probably need to look in the future at something which is far more personalized to this particular condition, targeted to the pathophysiology of Takotsubo itself rather than extrapolated from another condition. We need to do more work. We need to find out what really helps these patients in the long term.”
Takotsubo management should remain empirical and multidisciplinary; leaves open the need for large RCTs to define optimal strategies.
Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy, is an acute reversible form of left ventricular systolic dysfunction that mimics acute coronary syndrome in presentation. Once regarded as benign, TTS is now recognized to have a complicated in-hospital course in a substantial proportion of patients, with clinically significant events occurring in up to one third of cases, including cardiogenic shock, arrhythmias, thromboembolism, and death. Despite growing recognition, evidence-based management strategies remain limited due to the absence of randomized controlled trials. However, early evidence from small randomized trials is emerging in support of nonpharmacological interventions. This review provides a comprehensive synthesis of current therapeutic strategies for acute and long-term management of TTS, including pharmacological and nonpharmacological interventions such as cardiac rehabilitation, and management of psychiatric (eg, anxiety, depression) comorbidities, which increase the incidence of recurrences. As of today, TTS management remains largely empirical, relying on expert consensus and registry data focused on a multidisciplinary, personalized approach integrating cardiovascular, neurological, and psychological domains. Clinical trials and mechanistic research are needed to establish evidence-based therapies targeting the unique pathophysiology of TTS.
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Buono et al. (2026) conducted a review in Takotsubo syndrome. Therapeutic strategies was evaluated. Management of Takotsubo syndrome remains largely empirical, relying on expert consensus and a multidisciplinary approach due to the absence of randomized controlled trials.
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