Recurrence of Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy (TC) is transient systolic dysfunction of the left ventricle (LV) occurring mainly in post-menopausal women after a stressful event. It is associated with characteristic LV contraction patterns. While the prognosis for TC patients is generally favorable, some patients experience recurrence of TC, once or sometimes multiple times. This review summarizes current knowledge of recurrence of TC. Recurrence rate of TC has ranged from 0 to 10%. Although clinical correlates determining recurrence of TC have not been identified, the recurrence rate is higher in patients with severe LV dysfunction during initial TC event or younger female patients. Preventive therapy of recurrent TC has not been established. β-blockers are commonly used in the prevention of TC recurrence but no evidence to date supports their efficacy. Angiotensin converting enzyme inhibitors and angiotensin receptor blockers may have a role to prevent recurrence of TC. In patients with multiple recurrent TC triggered by emotional stress or suffering from anxiety disorder, psychological counseling or antianxiety drugs may be beneficial for preventing recurrence of TC.