Epidemiology, diagnosis, and treatment of Takotsubo syndrome: a comprehensive review

Abstract

Takotsubo syndrome (TTS) is characterized by apical or left ventricular (LV) ballooning and impaired wall motion as its primary features. Although women over 55 years make up the majority of TTS patients, male patients have a greater incidence of in-hospital mortality. TTS also impacts pregnant women and children, with conflicting information regarding racial differences. TTS has an in-hospital mortality rate comparable to that of acute ST-segment elevation myocardial infarction, and higher than that in patients with myocarditis. More than 10% of patients may experience a subsequent acute episode within 5 years after the initial event. TTS exhibits symptoms such as chest pain, electrocardiograph (ECG) abnormalities, elevated B-type natriuretic peptide (BNP), and N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP) levels, and changes in several imaging approaches, which may aid in early diagnosis. Fluid resuscitation, β-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), anti-anxiety or depression drugs, and cardiac rehabilitation may be employed to treat TTS, reduce recurrence rates, and improve functional exercise capacity and exercise time. After searching PubMed, Research Gate, Science Direct, and Web of Science, we summarized recent researches on epidemiology, diagnosis, treatments, and prognosis. These findings provide a theoretical basis for future clinical practice and will aid doctors and researchers investigating the unknown aspects of TTS.