Takotsubo Syndrome - Introduction

A Special Author Introduction
Coronary Artery Disease

ISSN: 0954-6928 • Frequency: 8/year • Subscribe Now • Journal Website

By Daniel M. Balkin and Lawrence S. Cohen

The Takotsubo Syndrome is being increasingly recognized as a distinct clinical syndrome.  It was first described 20 years ago by Japanese investigators.  It occurs primarily in post menopausal women although rare cases have been described in men. It is almost always triggered by an acute severe emotional stress although at rare times it seems to be caused by a high level of chronic stress.Severe chest pain is common and the electrocardiogram often mimics that seen with an acute myocardial infarction. 

An echocardiogram or a left ventriculogram resembles a Takotsubo, a Japanese octopus fishing pot.  A Takotsubo, in Japanese is “a fishing pot for trapping octopus”.  These traps have a round bottom and a narrow neck.  When the octopus enters the Takotsubo it is most often trapped while the fisherman pulls the device to the surface. The syndrome does not cause permanent damage.  Over a several week period all electrocardiographic and echocardiographic changes revert to normal.  The pathogenesis of this syndrome continues to be a topic of investigation.  It is likely that the emotional episode cause a catecholamine surge in an estrogen-deficient woman.  This leads to direct cardiomyocyte toxicity and likely constriction of the myocardial microvasculature.  With supportive therapy patient survival is the rule.

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