Takotsubo syndrome is an acute reversible heart failure syndrome that is increasingly recognised in
modern cardiology practice. This Position Statement from the ESC Heart Failure Association provides
a comprehensive review of the various clinical and pathophysiological facets of Takotsubo syndrome,
including nomenclature, definition and diagnosis, primary and secondary clinical subtypes,
anatomical variants, triggers, epidemiology, pathophysiology, clinical presentation, complications,
prognosis, clinical investigations and treatment approaches. Novel structured approaches to diagnosis,
risk stratification, and management are presented with new algorithms to aid decision-making by
practising clinicians. These also cover more complex areas (e.g. uncertain diagnosis and delayed
presentation) and the management of complex cases with ongoing symptoms after recovery, recurrent
episodes or spontaneous presentation. The unmet needs and future directions for research in this
syndrome are also discussed.