Treating the Broken Heart: Role of Stellate Ganglion Blockade in Takotsubo Syndrome

Takotsubo syndrome (TTS) is an acute stress-induced cardiomyopathy characterized by transient left ventricular dysfunction, often mimicking acute myocardial infarction but without obstructive coronary artery disease. Although typically reversible, TTS can be complicated by serious adverse events, including life-threatening ventricular arrhythmias. The pathophysiology is complex but strongly linked to sympathetic nervous system hyperactivity and a surge in catecholamines, often termed "neurogenic stunned myocardium." This review discusses the role of arrhythmias in TTS, the influence of the autonomic nervous system, and explores the rationale, mechanisms, and potential applications of stellate ganglion blockade, particularly left stellate ganglion blockade, in the management of TTS-related arrhythmias, illustrated by a clinical case.