A review of the presentation and outcome of takotsubo cardiomyopathy in COVID-19

Monaldi Arch Chest Dis. 2021 Mar 23;91(3). doi: 10.4081/monaldi.2021.1710.


Although the most frequent presentation of the novel Coronavirus disease-2019 (COVID-19) is a respiratory syndrome, cardiac involvement is being increasingly recognized. One such entity is takotsubo cardiomyopathy. We sought to review the various cases of takotsubo cardiomyopathy reported during the COVID-19 pandemic and consolidate the information available on its clinical features, evaluation and treatment. We performed a PubMed search using the MeSH terms "Takotsubo Cardiomyopathy" or "Stress Cardiomyopathy" and "COVID-19", and identified 16 case reports, two case series, and one retrospective cohort study. There was a total of 24 reported patients with COVID-19 infection, who developed takotsubo cardiomyopathy, and two patients without COVID-19 who developed takotsubo cardiomyopathy due to the emotional stress associated with the global pandemic. The mean age of the patients was 67.19 years (SD 15.83) and 16(59.3%) were women. Chest pain was reported in only ten patients (38.46 %) and ST-elevation was seen in 11 patients (42.3%). While most patients had typical takotsubo cardiomyopathy, four patients had inverted(reverse) takotsubo cardiomyopathy, two had bi-ventricular involvement, one had median takotsubo and another had global takotsubo with apical sparing variant. Most patients had a positive outcome with complete or near-complete reversal of cardiac dysfunction at the time of discharge. Five deaths (19.23%) were reported. Takotsubo cardiomyopathy is a rare, but increasingly reported reversible cardiomyopathy that can be seen in patients with COVID-19 infection and the diagnosis must be actively sought for in these patients.

Publication types

  • Review

MeSH terms

  • Aged
  • COVID-19*
  • Echocardiography
  • Female
  • Humans
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • Takotsubo Cardiomyopathy* / diagnosis
  • Takotsubo Cardiomyopathy* / epidemiology
  • Takotsubo Cardiomyopathy* / etiology