{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:58:16Z","timestamp":1784782696005,"version":"3.55.0"},"reference-count":95,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is complex and involves factors such as coronary vasospasm, microcirculatory dysfunction, increased catecholamine levels, and overactivity of the sympathetic nervous system. Diagnosing TTS requires a comprehensive approach, starting with clinical suspicion and progressing to both non-invasive and invasive multimodal tests guided by a specific diagnostic algorithm. Management of TTS should be personalized, considering potential complications, the presence or absence of coronary artery disease (CAD), diagnostic test results, and the patient\u2019s clinical course. The current data primarily derive from case series, retrospective analyses, prospective registries, and expert opinions. In recent years, there has been growing recognition of gender differences in the pathophysiology, presentation, and outcomes of TTS. This review provides an updated overview of gender disparities, highlighting the importance of tailored diagnostic and management strategies.<\/jats:p>","DOI":"10.3390\/jcm13164925","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T11:14:41Z","timestamp":1724325281000},"page":"4925","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1915-585X","authenticated-orcid":false,"given":"Simona","family":"Giubilato","sequence":"first","affiliation":[{"name":"Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina Maura","family":"Francese","sequence":"additional","affiliation":[{"name":"U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione \u201cGaribaldi\u201d, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Manes","sequence":"additional","affiliation":[{"name":"Cardiology Division, St Francesco Hospital, 87027 Paola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Rossini","sequence":"additional","affiliation":[{"name":"SC Cardiologia, Azienda Santa Croce e Carle, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4146-7099","authenticated-orcid":false,"given":"Roberta","family":"Della Bona","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, 16100 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gatto","sequence":"additional","affiliation":[{"name":"Cardiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-2056","authenticated-orcid":false,"given":"Antonio","family":"Di Monaco","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Zilio","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Santa Chiara Hospital, APSS, 38121 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Gasparetto","sequence":"additional","affiliation":[{"name":"Division of Cardiology, AULSS2 Marca Trevigiana, Ca\u2019 Foncello Hospital, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Sorini Dini","sequence":"additional","affiliation":[{"name":"U.O.C. Cardiologia Clinico Chirurgica (UTIC), A.O.U. Senese Ospedale Santa Maria alle Scotte, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Borrello","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Intensive Care Unit, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Mannarini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiothoracic Department, Azienda Consorziale Ospedaliera-Universitaria, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-8718","authenticated-orcid":false,"given":"Angela Beatrice","family":"Scardovi","sequence":"additional","affiliation":[{"name":"U.O.C. Cardiologia, Ospedale S. Spirito, 00123 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Pavan","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Sanitaria \u201cFriuli Occidentale\u201d, 33170 Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3662-9006","authenticated-orcid":false,"given":"Francesco","family":"Amico","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0092-8717","authenticated-orcid":false,"given":"Giovanna","family":"Geraci","sequence":"additional","affiliation":[{"name":"Cardiology Unit, S. Antonio Abate Hospital, ASP Trapani, 91016 Erice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Riccio","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Sant\u2019Anna e San Sebastiano Hospital, 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furio","family":"Colivicchi","sequence":"additional","affiliation":[{"name":"Cardiology Department, San Filippo Neri Hospital, ASL Roma 1, 00135 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-8884","authenticated-orcid":false,"given":"Massimo","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Regional Hospital \u201cF. 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