Current Concepts in the Pathogenesis of Takotsubo Syndrome.

Takotsubo syndrome is typically characterized by acute reversible impairment of apical and mid -left ventricular systolic function. The pathophysiology is complex and remains to be completely understood. A catecholamine surge appears to be a central feature. Patients with prior history of psychiatric disorders have a predisposition. The putative role of a switch in b-adrenoceptor signalling resulting in negative inotropy remains uncertain. Downregulation of noncritical cellular functions may offer some protection in preventing irreversible cellular necrosis. Microvascular function is a common occurrence in these patients.