Acute intraventricular obstruction: An underrecognized trigger of takotsubo cardiomyopathy in athletes in the setting of endurance activities

Dear Editor, Takotsubo cardiomyopathy (TTC), also known as takotsubo syndrome, has long been regarded as a stress-induced, transient clinical phenomenon characterized by specific myocardial wall motion abnormalities (1,2). In their recent article, Katib et al. analysed the characteristics of TTC in endurance athletes presenting in the context of marathon-related events (1), focusing in particular on the pathogenetic roles of excessive catecholamine release and microvascular dysfunction. We would like to underscore the pathogenetic and clinical implications of acute intraventricular obstruction as an additional mechanism of TTC in this population.