Takotsubo Cardiomyopathy: An Underrecognized Cardiac Emergency

Badugu Saikumar, Prasuna Gajula

Abstract: Takotsubo cardiomyopathy (TTC), also known as stress-induced cardiomyopathy or "broken heart syndrome", is a transient form of acute heart failure characterized by reversible left ventricular systolic dysfunction in the absence of significant obstructive coronary artery disease. Once considered a benign condition, TTC is now recognized as a clinically important cardiovascular syndrome associated with substantial morbidity and mortality, particularly during the acute phase. It predominantly affects postmenopausal women and is commonly triggered by emotional or physical stress, although cases without identifiable precipitating factors are increasingly recognized. The pathophysiology is multifactorial, involving catecholamine excess, autonomic nervous system dysregulation, coronary microvascular dysfunction, endothelial dysfunction, inflammation, oxidative stress, and genetic susceptibility. Clinically, TTC closely resembles acute coronary syndrome, presenting with chest pain, dyspnea, electrocardiographic abnormalities, and elevated cardiac biomarkers, making early and accurate diagnosis essential. Multimodality imaging, including echocardiography, coronary angiography, and cardiac magnetic resonance imaging, plays a pivotal role in confirming the diagnosis and excluding other cardiac disorders. Current management is primarily supportive and includes individualized hemodynamic stabilization, heart failure therapy, assessment for left ventricular outflow tract obstruction, anticoagulation in selected patients, and mechanical circulatory support in refractory cardiogenic shock. Although approximately 90-95% of patients recover left ventricular function within 4-8 weeks, acute complications such as cardiogenic shock, ventricular arrhythmias, thromboembolism, and heart failure remain significant concerns. Recent advances in strain imaging, artificial intelligence, molecular biomarkers, precision medicine, and wearable monitoring technologies are improving diagnostic accuracy, risk stratification, and long-term follow-up. This review summarizes the latest evidence regarding the epidemiology, pathophysiology, clinical presentation, diagnosis, management, prognosis, and future directions.

Keywords: Takotsubo cardiomyopathy, Stress-induced cardiomyopathy, Broken heart syndrome, Acute coronary syndrome, Left ventricular dysfunction, Echocardiography, Cardiogenic shock, Prognosis

How to Cite?: Badugu Saikumar, Prasuna Gajula, "Takotsubo Cardiomyopathy: An Underrecognized Cardiac Emergency", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 1463-1471, https://www.ijsr.net/getabstract.php?paperid=SR26715234740, DOI: https://dx.doi.org/10.21275/SR26715234740

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