RIGHT VENTRICULAR INVOLVEMENT IN TAKOTSUBO CARDIOMYOPATHY

Takotsubo cardiomyopathy (TTC) is a transient cardiac condition characterized by acute left ventricular dysfunction. While traditionally considered a left ventricular disorder, growing evidence suggests that right ventricular (RV) involvement is more common and clinically significant than initially thought. This review provides a comprehensive overview of RV involvement in TTC, focusing on its prevalence, pathophysiology, clinical presentation, diagnostic approaches, and management considerations. Recent studies estimate the prevalence of RV involvement in TTC at 25-50% of cases. The pathophysiology is complex, involving catecholamine surge, microvascular dysfunction, and ventricular interdependence. RV involvement is associated with worse clinical outcomes, including higher mortality and complication rates. Diagnosis relies on multimodal imaging, primarily echocardiography and cardiac MRI, along with biomarkers and hemodynamic assessment. Management of TTC with RV involvement requires a tailored approach, balancing supportive care with potential need for mechanical circulatory support. Challenges in diagnosis and management include differentiating from other conditions and limited RV-specific therapies. Special populations, such as the elderly and those with chronic lung disease, present unique considerations. Recent advances in imaging techniques and biomarker research show promise for improving early detection and risk stratification. Future perspectives include developing standardized diagnostic criteria, exploring targeted therapies, and establishing large-scale registries to advance our understanding of this complex condition. In conclusion, RV involvement in TTC significantly influences patient prognosis and management. Clinicians should maintain a high index of suspicion for RV involvement in all TTC cases and tailor their approaches accordingly. Continued research is crucial for enhancing our understanding and improving care for this patient population.