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Moreover, these patients have a substantial burden of morbidity and mortality, as well, with high rates of subsequent major adverse cardiovascular events that approach those of patients with acute coronary syndrome. The mechanisms behind this condition remain elusive. Despite substantial research, the medical community continues to have an incomplete understanding of its underlying pathogenesis and pathophysiology. Catecholamine-induced myocardial injury is the most established and well-known theory, but this does not explain all the clinical features and presentations of the condition, and numerous other pathways and abnormalities are emerging. Because of the poor understanding of its underlying pathophysiology, there is a lack of evidence-based interventions to treat the acute episode, to avoid recurrences, and to prevent major adverse cardiovascular events. This highlights the need for further research to gain a better understanding of the underlying pathophysiology to inform appropriate randomized controlled trials of interventions targeting the causative pathways. Only then can evidence-based management strategies be established to improve clinical outcomes of this potentially lethal condition.<\/jats:p>","DOI":"10.1161\/circulationaha.121.055854","type":"journal-article","created":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T14:00:18Z","timestamp":1648476018000},"page":"1002-1019","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":400,"title":["Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications"],"prefix":"10.1161","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4314-9935","authenticated-orcid":true,"given":"Trisha","family":"Singh","sequence":"first","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (T.S., C.S., D.E.N.)."},{"name":"Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, United Kingdom (H.K., D.T.G., D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0412-2227","authenticated-orcid":true,"given":"Hilal","family":"Khan","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (T.S., C.S., D.E.N.)."},{"name":"Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, United Kingdom (H.K., D.T.G., D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Gamble","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (T.S., C.S., D.E.N.)."},{"name":"Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, United Kingdom (H.K., D.T.G., D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Scally","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (T.S., C.S., D.E.N.)."},{"name":"Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, United Kingdom (H.K., D.T.G., D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7971-4628","authenticated-orcid":true,"given":"David E.","family":"Newby","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (T.S., C.S., D.E.N.)."},{"name":"Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, United Kingdom (H.K., D.T.G., D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2815-4469","authenticated-orcid":true,"given":"Dana","family":"Dawson","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (T.S., C.S., D.E.N.)."},{"name":"Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, United Kingdom (H.K., D.T.G., D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"56","volume-title":"In: Clinical Aspect of Myocardial Injury: From Ischemia to Heart Failure","author":"Sato TH","year":"1990","unstructured":"Sato, TH, Uchida, T, Dote, KMI. 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