Current knowledge and future challenges in takotsubo syndrome: Part 2-treatment and prognosis

Francesco Santoro*, Adriana Mallardi, Alessandra Leopizzi, Enrica Vitale, Elias Rawish, Thomas Stiermaier, Ingo Eitel, Natale D. Brunetti

*Corresponding author for this work
20 Citations (Scopus)


Takotsubo syndrome (TTS) represents a form of acute heart failure featured by reversible left ventricular systolic dysfunction. The management during the acute phase is mainly performed with supportive pharmacological (diuretics, ACE-inhibitors/angiotensin-receptor blockers (ARBs), anticoagulants, antiarrhythmics, non-catecholamine inotropics (levosimendan), and non-pharmacological (mechanical circulatory and respiratory support) therapy, due to the wide clinical presentation and course of the disease. However, there is a gap in evidence and there are no randomized and adequately powered studies on clinical effectiveness of therapeutic approaches. Some evidence supports the use ACE-inhibitors/ARBs at long-term. A tailored approach based on cardiovascular and noncardiovascular risk factors is strongly suggested for long-term management. The urgent need for evidence-based treatment approaches is also reflected by the prognosis following TTS. The acute phase of the disease can be accompanied by various cardiovascular complications. In addition, long term outcome of TTS patients is also related to non-cardiovascular comorbidities. Physical triggers such as hypoxia and acute neurological disorders in TTS are associated with a poor outcome.

Original languageEnglish
Article number468
JournalJournal of Clinical Medicine
Issue number3
Pages (from-to)1-9
Number of pages9
Publication statusPublished - 01.02.2021

Research Areas and Centers

  • Centers: Cardiological Center Luebeck (UHZL)

DFG Research Classification Scheme

  • 205-12 Cardiology, Angiology


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