Epidemiological Profile of Takotsubo Syndrome: A Review

Abstract

Background: Takotsubo syndrome is an acute and usually reversible form of myocardial dysfunction that often resembles acute coronary syndrome. Its epidemiological profile has become increasingly relevant as diagnostic awareness and access to cardiac imaging have improved. Objective: This literature review describes the epidemiological profile of Takotsubo syndrome, with emphasis on incidence, demographic characteristics, risk factors, triggers, clinical phenotypes, prognosis, recurrence, and remaining gaps in knowledge. Methods: A narrative literature review was conducted using PubMed, Scopus, and Google Scholar. Studies published mainly between 2000 and 2026 were considered. Priority was given to major registries, observational studies, systematic reviews, meta-analyses, and consensus documents relevant to epidemiology and clinical outcomes. Results: Takotsubo syndrome accounts for approximately 1-3% of suspected acute coronary syndrome presentations and occurs predominantly in postmenopausal women, who represent about 80-90% of reported cases. The typical age range is 60-75 years. Emotional stressors are classically associated with the syndrome; however, physical triggers, including acute neurological events, infection, surgery, trauma, respiratory failure, malignancy, and critical illness, are increasingly recognised and are linked to less favourable outcomes. Psychiatric and neurological disorders are frequent comorbidities, supporting the relevance of brain-heart interactions. Although left ventricular systolic function usually recovers, acute complications may include heart failure, cardiogenic shock, arrhythmias, thromboembolism, recurrence, and death. Recurrence is reported in approximately 5-10% of patients during follow-up. Increased reporting during the COVID-19 pandemic further illustrates the potential influence of psychological stress, systemic illness, and inflammatory mechanisms. Conclusion: Takotsubo syndrome is clinically important and probably underdiagnosed. Its epidemiology is characterised by female predominance, older age, stress-related triggers, heterogeneous clinical severity, and limited data from low- and middle-income regions, particularly African populations.