Takotsubo cardiomyopathy: a clinical review.

Takotsubo cardiomyopathy is a reversible cardiomyopathy which has increasingly been recognized in the differential diagnosis of patients presenting with acute coronary syndrome. It is characterized by transient systolic ventricular dysfunction with regional wall motion abnormalities beyond a single vascular territory and in the absence of significant epicardial coronary artery obstruction. Often, there is an acute emotional or physical stressor immediately preceding the presentation. Classical apical ballooning is seen on ventriculography or echocardiography but variants with isolated basal or mid wall akinesis have been described. Catecholamine excess and cardiotoxicity is the most compelling putative mechanism. The long-term prognosis is excellent but serious complications including cardiogenic shock and arrhythmias may occur acutely. Supportive treatment is the mainstay of therapy.