Takotsubo Syndrome: A Complex and Varied Clinical Syndrome

This special issue includes expert reviews and original research on Takotsubo syndrome (TTS) including the history of its identification and the unravelling of the pathophysiology of the different variants of the syndrome. The role of neurological stress or catecholaminergic overload are reviewed, as is the role of CNS disorders triggering TTS. Clinical presentation patterns of TTS and the most useful diagnostic tests are reviewed, including original research into a novel clinical score the ‘GET QT' score to help in rapid differentiation of TTS from STEMI. There is also a review of TTS in the intensive care unit setting.  The mechanisms of TTS including the role and assessment of the microcirculation in generating the classical myocardial dysfunction are reviewed in detail, as are the pathophysiological pathways of recurrent TTS. Lastly Singh, Akashi and Horowitz review the emerging treatment options for TTS. They issue also includes multiple elegant and fascinating case reports. TTS has come of age and now urgently adequate sized RCT’s.