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Eur Heart J. 2018 Jun 7;39(22):2032-2046. doi: 10.1093/eurheartj/ehy076.

International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology.

Author information

1
University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
2
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
3
Division of Cardiovascular Diseases Mayo Clinic, Rochester, MN, USA.
4
Cardiovascular Research Division, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA.
5
Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
6
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
7
Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Rome, Italy.
8
Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium.
9
Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
10
Department of Cardiovascular Medicine, Onga Nakama Medical Association Onga Hospital, Fukuoka, Japan.
11
Clinica Medica, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
12
University Heart Center Luebeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Luebeck, Luebeck, Germany.
13
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
14
Department of Cardiology, University Hospital Giessen, Giessen, Germany.
15
Heart Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
16
Department of Anatomy and Cell Biology, Wakayama Medical University School of Medicine, Wakayama, Japan.
17
Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua Medical School, Padova, Italy.
18
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
19
Division of Cardiovascular Disease, Department of Medicine, University of Florida, Gainesville, FL, USA.
20
NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK.
21
National Heart and Lung Institute, Imperial College, London, UK.
22
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
23
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
24
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
25
Department of Cardiology and Intensive Care, Centre Hospitalier de Compiegne, Compiegne, France.
26
Department of Cardiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
27
Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia.
28
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
29
Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Zurich, Switzerland.
30
Department of Cardiology, Royal Brompton & Harefield Hospital and Imperial College, London, UK.

Abstract

Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated with severe clinical complications including death and that its prevalence is probably underestimated. Since current guidelines on TTS are lacking, it appears timely and important to provide an expert consensus statement on TTS. The clinical expert consensus document part I summarizes the current state of knowledge on clinical presentation and characteristics of TTS and agrees on controversies surrounding TTS such as nomenclature, different TTS types, role of coronary artery disease, and etiology. This consensus also proposes new diagnostic criteria based on current knowledge to improve diagnostic accuracy.

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