Acute stress-induced (takotsubo) cardiomyopathy

Heart. 2018 Jan;104(2):96-102. doi: 10.1136/heartjnl-2017-311579. Epub 2017 Aug 20.


Acute stress-induced (takotsubo) cardiomyopathy has a dramatic clinical presentation, mimicking an acute myocardial infarction and is triggered by intense emotional or physical stress. In this paper, we review the current state of knowledge of the mechanistic physiology underlying the left ventricular ballooning. The pathophysiology of the recovery from this acute heart failure syndrome is presented. The short-term and long-term outlook puts this new syndrome on a different perspective compared with recently held views. Current knowledge on susceptibility and predisposition already define distinctive characteristics of patients with takotsubo compared with myocardial infarction. Gaps in knowledge and future directions of research are identified in order to best direct efforts for identifying specific therapies for this condition, in the acute setting, to mitigate postacute symptoms or to prevent recurrences, none of which exist.

Keywords: acute stress induced cardiomyopathy; broken heart syndrome; cardiomyopathy; takotsubo.

Publication types

  • Review

MeSH terms

  • Heart Ventricles / physiopathology*
  • Humans
  • Recovery of Function
  • Risk Factors
  • Secondary Prevention
  • Takotsubo Cardiomyopathy* / diagnosis
  • Takotsubo Cardiomyopathy* / etiology
  • Takotsubo Cardiomyopathy* / physiopathology