Takotsubo Syndrome: Clinical Features, Pathogenesis, Treatment, and Relationship with Cerebrovascular Diseases

  • M. Ranieri
  • J. Finsterer
  • G. Bedini
  • E. A. Parati
  • A. Bersano
Stroke (H Diener, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Stroke


Purpose of Review

This review paper aims to provide a complete and updated overview on the clinical and pathophysiological aspects of Takotsubo syndrome (TTS), including prognosis, therapy, and the association with cerebrovascular conditions.

Recent Findings

TTS is an increasingly recognized non-ischemic cardiomyopathy characterized by sudden, temporary weakening of the myocardium, of which the pathogenesis is unknown.


Although pathogenesis of TTS remains unclear, a complex interaction between catecholamine-mediated stimulation, myocardial stunning, and subsequent stress-related myocardial dysfunction seems to be the main pathophysiological mechanism. Stroke is linked to TTS by a dual relationship since it may induce TTS by catecholamine release even if TTS itself also may be complicated by left ventricular thrombi leading to stroke. Given its possible complications, including the association with neurological diseases, both cardiologist and neurologists should be aware about TTS in order to diagnose it promptly and to initiate appropriate therapeutic measures.


Diagnosis Ischemic stroke Subarachnoid hemorrhage Pathogenesis Takotsubo syndrome Therapy 



All the authors contributed to drafting the article or revising it critically for important intellectual content and finally approved the last version to be published.

Compliance with Ethical Standards

Conflict of Interest

Ranieri M., Finsterer J., Bedini G., Parati E.A., and Bersano A. declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • M. Ranieri
    • 1
  • J. Finsterer
    • 2
  • G. Bedini
    • 3
  • E. A. Parati
    • 1
  • A. Bersano
    • 1
    • 4
  1. 1.Cerebrovascular Disease Unit, IRCCS Foundation “C. Besta”Neurological InstituteMilanItaly
  2. 2.Krankenanstalt RudolfstiftungViennaAustria
  3. 3.Laboratory of Cellular Neurobiology, IRCCS Foundation “C. Besta”Neurological InstituteMilanItaly
  4. 4.Fondazione IRCCS Istituto Neurologico “Carlo Besta”MilanItaly

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