COVID-19 and Takotsubo Cardiomyopathy: An integrative review

Abstract

Coronavirus 2019 (COVID-19), Takotsubo cardiomyopathy (CT) stands out. Also known as broken heart syndrome, it is a rare dysfunction that affects the systolic function of the left ventricle, resulting from an abrupt and intense discharge of catecholamines, of a transient and reversible nature. However, the coexistence of CT and COVID-19 results in an intense cytokine storm, which makes the outcome not so favorable, with increased risks for cardiogenic shock, myocarditis, and cardiac tamponade. Thus, the objective of this study was to analyze scientific evidence on the relationship between COVID-19 and CT in healthy patients or patients with controlled systemic diseases (without complications). An integrative literature review was carried out in the MEDLINE database, with the strategies “Takotsubo Syndrome and COVID-19” and “Takotsubo Syndrome and SARS-Cov-2”. Initially, a total of 194 references were obtained which, after critical analysis by the researchers, included 5 case reports in this review. The investigation of the cases did not identify specific patterns of clinical manifestations, laboratory tests or imaging in healthy patients or with controlled systemic diseases, but in general, the occurrence of cytokine storms with impacts on the coagulation cascade and on the patterns can be highlighted. of cardiac functioning. Thus, we emphasize the importance of including CT as a differential diagnosis in the face of the poor prognosis of the patient with COVID-19 and that studies continue to be carried out to better elucidate this issue which, although rare, can be fatal.