title: Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology.
abstract: Takotsubo syndrome is an acute reversible heart failure syndrome that is increasingly recognized in modern cardiology practice. This Position Statement from the European Society of Cardiology Heart Failure Association provides a comprehensive review of the various clinical and pathophysiological facets of Takotsubo syndrome, including nomenclature, definition, and diagnosis, primary and secondary clinical subtypes, anatomical variants, triggers, epidemiology, pathophysiology, clinical presentation, complications, prognosis, clinical investigations, and treatment approaches. Novel structured approaches to diagnosis, risk stratification, and management are presented, with new algorithms to aid decision-making by practising clinicians. These also cover more complex areas (e.g. uncertain diagnosis and delayed presentation) and the management of complex cases with ongoing symptoms after recovery, recurrent episodes, or spontaneous presentation. The unmet needs and future directions for research in this syndrome are also discussed.
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.|NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Lyon
authors.affiliation: Cardiology Division, 'Cava de Tirreni and Amalfi Coast' Hospital, Heart Department, University of Salerno, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
authors.affiliation: Medizinische Klinik II, Sana Kliniken Lübeck, Germany.
authors.forename: Birke
authors.initials: B
authors.lastname: Schneider
authors.affiliation: Department of Cardiology, Robert Bosch Krankenhaus, Stuttgart, Germany.
authors.forename: Udo
authors.initials: U
authors.lastname: Sechtem
authors.affiliation: University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Heart Department, Largo Città di Ippocrate, Salerno, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.|NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK.
authors.forename: S Richard
authors.initials: SR
authors.lastname: Underwood
authors.affiliation: Department of Cardiovascular Pathology, St George's University Medical School, London, UK.
authors.forename: Mary N
authors.initials: MN
authors.lastname: Sheppard
authors.affiliation: North Shore Heart Research, Kolling Institute, University of Sydney, Australia.|Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Gemma A
authors.initials: GA
authors.lastname: Figtree
authors.affiliation: Invasive Cardiology, Careggi Hospital, Florence, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Parodi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Yoshihiro J
authors.initials: YJ
authors.lastname: Akashi
authors.affiliation: Clinic for Cardiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Frank
authors.initials: F
authors.lastname: Ruschitzka
authors.affiliation: Department of Cardiology, Attikon University Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
authors.affiliation: Université Paris Diderot; U942 Inserm, Département d'Anestéhsie-Réanimation Hôpitaux Universitaires Saint Louis-Lariboisière, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
authors.affiliation: Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Elmir
authors.initials: E
authors.lastname: Omerovic
mesh_terms: D002309:Cardiology / Q000379:methods / Q000458:organization & administration; D019468:Disease Management; D005060:Europe; D006801:Humans; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy
keywords: Takotsubo syndrome; heart failure; risk stratification; stress