A review of the presentation and outcome of Takotsubo cardiomyopathy in COVID-19



  • Kevin John | kevinjohn619@gmail.com Department of Critical Care, Bangalore Baptist Hospital, Bellary Road, Hebbal, Bengaluru, Karnataka, India. https://orcid.org/0000-0003-3382-0294
  • Amol Lal Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester MN, United States. https://orcid.org/0000-0002-0021-2033
  • Ajay Kumar Mishra Department of Medicine, Saint Vincent Hospital, Worcester, MA, United States.


Although the most frequent presentation of the novel Coronavirus disease-2019 (COVID-19) is a respiratory syndrome, cardiac involvement is being increasingly recognized. One such entity is takotsubo cardiomyopathy. We sought to review the various cases of takotsubo cardiomyopathy reported during the COVID-19 pandemic and consolidate the information available on its clinical features, evaluation and treatment. We performed a PubMed search using the MeSH terms “Takotsubo Cardiomyopathy” or “Stress Cardiomyopathy” and “COVID-19”, and identified 16 case reports, two case series, and one retrospective cohort study. There was a total of 24 reported patients with COVID-19 infection, who developed takotsubo cardiomyopathy, and two patients without COVID-19 who developed takotsubo cardiomyopathy due to the emotional stress associated with the global pandemic. The mean age of the patients was 67.19 years (SD 15.83) and 16(59.3%) were women. Chest pain was reported in only ten patients (38.46 %) and ST-elevation was seen in 11 patients (42.3%). While most patients had typical takotsubo cardiomyopathy, four patients had inverted(reverse) takotsubo cardiomyopathy, two had bi-ventricular involvement, one had median takotsubo and another had global takotsubo with apical sparing variant. Most patients had a positive outcome with complete or near-complete reversal of cardiac dysfunction at the time of discharge. Five deaths (19.23%) were reported. Takotsubo cardiomyopathy is a rare, but increasingly reported reversible cardiomyopathy that can be seen in patients with COVID-19 infection and the diagnosis must be actively sought for in these patients.



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COVID-19 - Collection of articles on the Coronavirus outbreak
COVID-19; Takotsubo cardiomyopathy; Cardiomyopathy
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How to Cite
John, Kevin, Amos Lal, and Ajay Mishra. 2021. “A Review of the Presentation and Outcome of Takotsubo Cardiomyopathy in COVID-19”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2021.1710.