Sport-related Takotsubo Syndrome: a review of case-reports

Scientific literature describes physical exercise as one of the potential triggering factors of Takotsubo Syndrome (TTS), an acute stress-induced clinical entity characterized by transient myocardial dysfunction. Acute exercise represents a paradigmatic example of a stress event, able to activate the hypothalamic-pituitary-adrenal axis and the autonomic sympathetic nervous system. The consequent release of catecholamine has the aim to improve physical and mental performance. In predisposed individuals, the surge in catecholamine levels associated with exercise may trigger the onset of TTS. Clinical cases showing TTS following sport participation are increasingly been reported. The diagnosis of TTS should be taken into account when dealing with a patient presenting with chest pain and/or dyspnea, slight increase in troponin levels, left ventricular dysfunction, and normal coronary arteries, after participation to sport activities. The present review describes case-reports of sport-related TTS. Demographics characteristics, medical history, symptoms at presentation, values of laboratory parameters, findings on electrocardiogram, transthoracic echocardiography, chest X-ray, coronary angiography, and cardiac magnetic resonance as well as patients' management and outcomes are summarized.