IMR Press / RCM / Volume 23 / Issue 4 / DOI: 10.31083/j.rcm2304131
Open Access Review
Takotsubo Syndrome in the Emergency Room — Diagnostic Challenges and Suggested Algorithm
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1 Department of Cardiology, Galilee Medical Center, 2210001 Nahariya, Israel
2 Azrieli Faculty of Medicine, Bar Ilan University, 1311502 Safed, Israel
*Correspondence: (Gassan Moady)
Academic Editor: David Winchester
Rev. Cardiovasc. Med. 2022, 23(4), 131;
Submitted: 16 January 2022 | Revised: 17 February 2022 | Accepted: 18 February 2022 | Published: 8 April 2022
(This article belongs to the Special Issue Evaluation of Chest Pain in the Emergency Department)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Takotsubo syndrome is an important condition to consider among patients with acute chest pain in the emergency room. It often mimics acute coronary syndrome since chest pain and ECG changes are key features in both conditions. The hallmark of takotsubo syndrome is transient left ventricular dysfunction (characterized by apical ballooning) followed by complete echocardiographic recovery in most cases. Although most patients exhibit a benign course, lethal complications may occur. The use of hand-held point-of-care focused cardiac ultrasound may be helpful for early identification of takotsubo syndrome and distinguishing it from acute coronary syndrome and other cardiovascular emergencies. Emergency room physicians should be familiar with typical and atypical presentations of takotsubo syndrome and its key electrocardiographic changes. The approach in the emergency room should be based on a combination the clinical presentation, ECG, and handheld echocardiography device findings, rather than a single electrocardiographic algorithm.

takotsubo syndrome
acute coronary syndrome
point-of-care focused cardiac ultrasound
Fig. 1.
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