[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-461396-105":59,"doc-detail-461396-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","takotsubo-syndrome-in-2025-evolving-concepts-in-pathophysiology-diagnosis-and-long-term-management","Takotsubo Syndrome in 2025 - Evolving Concepts in Pathophysiology, Diagnosis, and Long-Term Management","","Takotsubo syndrome (TTS) is an acute condition characterized by left ventricular dysfunction that can clinically resemble acute coronary syndrome in the absence of obstructive coronary disease or congestive heart failure. Once considered benign, TTS is now recognized as a multifactorial neurocardiac disorder with hospital morbidity comparable to myocardial infarction and similar long-term risks. Current evidence links catecholamine overload, coronary microvascular dysfunction, myocardial energetic abnormalities, and brain–heart axis dysregulation. Advances in echocardiography and cardiac MRI, alongside refined diagnostic criteria, support recognition of distinct phenotypes.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/takotsubo-syndrome-in-2025-evolving-concepts-in-pathophysiology-diagnosis-and-long-term-management/461396/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/takotsubo-syndrome-in-2025-evolving-concepts-in-pathophysiology-diagnosis-and-long-term-management/461396.png","ImageObject",300,407,{"name":92,"@type":93},"Blitz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-11","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How does Takotsubo syndrome present clinically compared with acute coronary syndrome?","Question",{"text":113,"@type":114},"Takotsubo syndrome can mimic acute coronary syndrome, while occurring without obstructive coronary artery disease or congestive heart failure.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What main mechanisms does recent evidence associate with Takotsubo syndrome?",{"text":118,"@type":114},"Evidence supports a multifactorial process involving catecholamine overload, coronary microvascular dysfunction, myocardial energetic abnormalities, and dysregulation of the brain–heart axis.",{"name":120,"@type":111,"acceptedAnswer":121},"What diagnostic advances help improve recognition of Takotsubo syndrome?",{"text":122,"@type":114},"Developments in echocardiography and cardiac magnetic resonance imaging, together with improved diagnostic criteria, enhance recognition of syndromic phenotypes.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},461396,1790794676,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},24464137899374,"https://us-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Review  \nTakotsubo Syndrome in 2025: Evolving Concepts in  \nPathophysiology, Diagnosis, and Long-Term Management  \nAlyssa McKenzie 1, * and Raed Bargout 2  \nAcademic Editor: Gian Luigi Nicolosi  \nReceived: 28 November 2025  \nRevised: 22 December 2025  \nAccepted: 23 December 2025  \nPublished: 26 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 School of Medicine, St. Georges University, West Indies 11739, Grenada  \n2 Dignity Glendale Memorial Hospital, Glendale, CA 91204, USA  \n* Correspondence: [allyrosemckenzie@gmail.com](allyrosemckenzie@gmail.com)  \nAbstract  \nTakotsubo syndrome (TTS) is an acute condition involving left ventricular dysfunction that may present clinically as acute coronary syndrome without obstructive coronary disease or congestive heart failure. Initially considered benign, TTS is now recognized as a complex neurocardiac disorder with hospital morbidity rates comparable to those of myocardial infarction, as well as similar long-term risks. Recent evidence establishes TTS as a multifactorial process involving catecholamine overload, coronary microvascular dysfunction, myocardial energetic abnormalities, and dysregulation of the brain and heartaxes. Developments in echocardiography, cardiac magnetic resonance imaging, and improvements in diagnostic criteria have enhanced the recognition of syndromic phenotypes. Management of TTS continues to remain primarily supportive; however, recent studies have revealed improved functional outcomes with structured cardiac rehabilitation and cognitive behavioral therapies as the first long-term disease-altering approaches. Future studies should combine neurocardiology, imaging, and therapy-focused research. This review integrates the understanding of the epidemiology, pathophysiology, clinical features, diagnostic work-up, and management of TTS, with particular emphasis on developments emerging from the past decade.  \nKeywords: Takotsubo syndrome; stress cardiomyopathy; broken heart syndrome; catecholamines; microvascular dysfunction; brain–heart axis; heart failure  \n1. Introduction  \nTakotsubo syndrome (TTS), also referred to as takotsubo cardiomyopathy, stress cardiomyopathy, or “broken heart syndrome,” is an acute and typically reversible form of left ventricular systolic dysfunction that clinically mimics acute coronary syndrome in the absence of obstructive coronary artery disease [1–3] . First described in Japan in 1990, the condition derives its name from the characteristic apical ballooning appearance resembling a takotsubo, a traditional octopus trap [4,5] .  \nInitially regarded as a benign event, TTS is now identified as an acute heart failure syndrome associated with increased chronic hospitalization and mortality rates that are almost equivalent to those associated with myocardial infarction [1,2,6,7] . Large international registries, including the International Takotsubo (InterTAK) Registry and the Heart Failure Association (HFA) of the European Society of Cardiology, have described the epidemiology, diagnostic criteria, and heterogeneous clinical presentations [2,3,6,8] .  \nAdvances over the past decade in cardiac imaging, neurocardiology, and coronary physiology have expanded current understanding of TTS to be a multifactorial disorder  \ninvolving complex interactions. Despite normalization of left ventricular ejection fraction, accumulating evidence suggests many individuals experience persistent symptoms, subclinical dysfunction, and increased long-term risk, challenging the traditional concept of complete recovery [9–12] . Neuroimaging studies further implicate alterations within central autonomic networks, supporting a role for brain–heart axes in both vulnerability and recovery [13–16] .  \nAlthough numerous reviews have addressed individual aspects of TTS, many foundational publi","cbCaihBf87m9TzPW","https://ap.wps.com/l/cbCaihBf87m9TzPW","pdf",1385740,23,"English","# Abstract\n# Introduction\n# Definitions, Nomenclature, and Classification\n## Historical Background\n## Core Diagnostic Elements","[{\"question\":\"How does Takotsubo syndrome present clinically compared with acute coronary syndrome?\",\"answer\":\"Takotsubo syndrome can mimic acute coronary syndrome, while occurring without obstructive coronary artery disease or congestive heart failure.\"},{\"question\":\"What main mechanisms does recent evidence associate with Takotsubo syndrome?\",\"answer\":\"Evidence supports a multifactorial process involving catecholamine overload, coronary microvascular dysfunction, myocardial energetic abnormalities, and dysregulation of the brain–heart axis.\"},{\"question\":\"What diagnostic advances help improve recognition of Takotsubo syndrome?\",\"answer\":\"Developments in echocardiography and cardiac magnetic resonance imaging, together with improved diagnostic criteria, enhance recognition of syndromic phenotypes.\"}]","Takotsubo Syndrome in 2025 - Evolving Concepts in Pathophysiology, Diagnosis, and Long-Term Management | PDF",1790761508,58]