Characteristics of coronary microcirculatory function in patients with Takotsubo syndrome

Takotsubo syndrome (TS) is an infrequent syndrome characterized by systolic dysfunction that usually gives a circumferential involvement of the basal and apical segments of the left ventricle (1-3). It is frequently related to acute physical and psychological stress and it is generally reversible (1). From a clinical standpoint, it strongly mimics an acute coronary syndrome (chest pain at rest and/or dyspnea), however coronary angiography reveals the absence of obstructive coronary artery disease or acute plaque rupture (1,3-5). The syndrome has found its own clinical and diagnostic identity only in recent years and it was included by the American Heart Association (AHA) in the classification of cardiomyopathies, as acquired cardiomyopathy (2). More recently the position paper of the ESC suggested using the term “syndrome” instead of cardiomyopathy because the full recovery of patients and the low rate of major adverse cardiac events at follow-up in reported series strongly suggest that TS is different from the primary cardiomyopathies (6)