Takotsubo syndrome

Abstract

Takotsubo syndrome (TTS), a form of non-ischaemic cardiomyopathy characterized by a peculiar pattern of transient left ventricular (LV) systolic dysfunction, has drawn increasing research interest in the last decade. While clinical and epidemiological features have been well characterized, the main pathophysiological mechanism of TTS remains largely unknown. Cardiovascular magnetic resonance (CMR) imaging is uniquely suited for the evaluation of patients with TTS. In addition to identifying the typical regional wall motion abnormalities, it allows for precise quantification of right ventricular and LV function, the assessment of additional abnormalities/complications (e.g. pericardial and/or pleural effusion, LV thrombi), and most importantly myocardial tissue characterization (myocardial oedema, inflammation, necrosis/fibrosis). Thus, CMR enables a comprehensive assessment of the entire spectrum of functional and structural changes that occur in patients with TTS. This chapter outlines the role of CMR in TTS and demonstrates that CMR provides important diagnostic information and allows for verifying all relevant functional and tissue criteria to establish or rule out the diagnosis of TTS.