Takotsubo syndrome is a disorder characterized by abrupt transitory left ventricular systolic dysfunction, which can be difficult to identify from acute myocardial infarction at presentation. Although takotsubo syndrome was previously thought to be a benign, self-limiting condition, recent studies have confirmed that patients with the condition have persistent subtle ongoing cardiac dysfunction, and many continue to have limited symptoms despite restoration of left ventricular ejection fraction.

Furthermore, these patients bear a significant morbidity and death burden, with rates of future major adverse cardiovascular events approaching those of patients with acute coronary syndrome. The processes behind this disease were unknown. Despite extensive study, the medical community still has imperfect knowledge of its etiology and pathophysiology. The most established and well-known explanation is catecholamine-induced myocardial damage. However, it does not explain all clinical symptoms and presentations of the illness, and various additional routes and abnormalities are developing. 

Due to a lack of knowledge of its underlying pathophysiology, there was a paucity of evidence-based therapies to manage the acute episode, reduce recurrences, and prevent significant adverse cardiovascular events. Therefore, it emphasized the importance of the additional study to get a better knowledge of the underlying pathophysiology to design adequate randomized controlled trials of therapies targeting the causal pathways. Only then can evidence-based management options be devised to enhance clinical outcomes of this potentially fatal illness.

Reference:www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055854