Indications of beta-adrenoceptor blockers in Takotsubo syndrome and theoretical reasons to prefer agents with vasodilating activity

Takotsubo syndrome (TTS) is estimated to account for 1–3% of all patients presenting with suspected ST-segment elevation myocardial infarction. A sudden surge in sympathetic nervous system considered the cause TTS. Nonetheless, no specific recommendations have been provided regarding β-blocking therapy. Apart from contra-indications (severe LV dysfunction, hypotension, bradycardia and corrected QT interval >500 ms), treatment a β-blocker seems reasonable until full recovery ejection fraction, though evidence limited few animal studies, case reports or observational studies. In this review, we will reappraise rationale therapy TTS speculate on pathophysiologic basis preferring non-selective agents vasodilating activity over β1-selective drugs.