Takotsubo Cardiomyopathy

Abstract

Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy or "broken heart syndrome," is a transient cardiac condition characterized by acute left ventricular dysfunction, often triggered by emotional or physical stress. It mimics acute coronary syndrome (ACS) in its presentation, with symptoms such as chest pain, dyspnea, and electrocardiographic changes, but lacks significant coronary artery obstruction on angiography. The hallmark of TCM is regional wall-motion abnormalities of the left ventricle, typically involving apical ballooning. The underlying pathophysiology is not fully understood, but it is hypothesized to involve catecholamine surge-induced myocardial stunning, microvascular dysfunction, or direct myocyte injury. TCM predominantly affects postmenopausal women and has a generally favourable prognosis, with most patients recovering normal cardiac function within weeks. However, complications such as heart failure, arrhythmias, and cardiogenic shock can occur in severe cases. Diagnosis requires integration of clinical, imaging, and laboratory findings to differentiate TCM from other cardiac conditions. Echocardiography and cardiac magnetic resonance imaging (MRI) are critical for evaluating ventricular function and ruling out alternative diagnoses. Management is primarily supportive, focusing on symptom control, hemodynamic stabilization, and addressing potential triggers. Long-term outcomes are generally good, but recurrence is possible, emphasizing the need for continued research into prevention and pathophysiological mechanisms.