Zehan IG, Eötvös CA, Moldovan MP
… +13 more, Andrei MG, Șchiop-Țentea CP, Lazar RD, Sârb AD, Coșeriu G, Avram T, Șerban A, Gușetu G, Mocan-Hognogi LD, Chiorescu R, Pop S, Heist EK, Blendea D
Curr Cardiol Rep
· 2025 Feb · PMID 39969647
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PURPOSE OF REVIEW: This review aims to synthesize current knowledge on the angiographic anatomy of the coronary sinus and its tributaries veins, with focus on venous branches other than classical ones used in cardiac res...PURPOSE OF REVIEW: This review aims to synthesize current knowledge on the angiographic anatomy of the coronary sinus and its tributaries veins, with focus on venous branches other than classical ones used in cardiac resynchronization therapy. It also presents common anatomical aspects that could impact the clinical outcome. RECENT FINDINGS: Recent advancements in the electrophysiology field, like epicardial arrhythmia mapping and ablation through coronary sinus or cardiac pacing from atypical veins requires a detailed angiographic assessment of cardiac veins. There is an increased interest for the veins coursing in the left ventricular summit (LVS) area and could potentially provide a pathway to reach the LVS arrhythmogenic foci. However, there is no consensus regarding the nomenclature and classification of these veins. This review could offer a better understanding of the coronary sinus and its tributary veins distribution, dimensions and relationship with nearby structures that could help the development of new ablation and pacing tools and strategies, with higher success rates.
Curr Cardiol Rep
· 2025 Feb · PMID 39969632
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PURPOSE OF REVIEW: The inclusion of immunomodulatory strategies as supportive therapies in ischemic heart disease (IHD) has garnered significant support over recent years. Several such approaches appear to be unified thr...PURPOSE OF REVIEW: The inclusion of immunomodulatory strategies as supportive therapies in ischemic heart disease (IHD) has garnered significant support over recent years. Several such approaches appear to be unified through their ultimate target, the NLRP3 inflammasome. This review presents a brief update on immunomodulatory strategies in the continuum of conditions constituting ischemic heart disease and emphasising on the seemingly unifying mechanism of NLRP3 activation as well as modulation across these conditions. RECENT FINDINGS: The NLRP3 inflammasome is a multiprotein complex assembled upon inflammatory stimulation, causing the release of pro-inflammatory cytokines and initiating pyroptosis. The NLRP3 pathway is relevant in inflammatory signalling of cardiac immune cells as well as non-immune cells in the myocardium, including cardiomyocytes, fibroblasts and endothelial cells. In addition to a focus on clinical outcome and efficacy trials of targeting NLRP3-related pathways, the potential connection between immunomodulation in cardiology and the NLRP3 pathway is currently being explored in preclinical trials. Colchicine, cytokine-based approaches and SGLT2 inhibitors have emerged as promising agents. However, the conditions comprising IHD including atherosclerosis, coronary artery disease (CAD), myocardial infarction (MI) and ischemic cardiomyopathy/heart failure (iCMP/HF) are not equally amenable to immunomodulation with the respective drugs. Atherosclerosis, coronary artery disease and ischemic cardiomyopathy are affected by chronic inflammation, but the immunomodulatory approach to acute inflammation in the post-MI setting remains a pharmacological challenge, as detrimental and regenerative effects of myocardial inflammation are initiated in unison. The NLRP3 inflammasome lies at the center of cell mediated inflammation in IHD. Recent trial evidence has highlighted anti-inflammatory effects of colchicine, interleukin-based therapy as well as SGLT2i in IHD and that the respective drugs modulate the NLRP3 inflammasome.
PURPOSE OF REVIEW: This review explores the role of artificial intelligence (AI) in cardio-oncology, focusing on its latest application across problems in diagnosis, prognosis, risk stratification, and management of card...PURPOSE OF REVIEW: This review explores the role of artificial intelligence (AI) in cardio-oncology, focusing on its latest application across problems in diagnosis, prognosis, risk stratification, and management of cardiovascular (CV) complications in cancer patients. It also highlights multi-omics analysis, explainable AI, and real-time decision-making, while addressing challenges like data heterogeneity and ethical concerns. RECENT FINDINGS: AI can advance cardio-oncology by leveraging imaging, electronic health records (EHRs), electrocardiograms (ECG), and multi-omics data for early cardiotoxicity detection, stratification and long-term risk prediction. Novel AI-ECG models and imaging techniques improve diagnostic accuracy, while multi-omics analysis identifies biomarkers for personalized treatment. However, significant barriers, including data heterogeneity, lack of transparency, and regulatory challenges, hinder widespread adoption. AI significantly enhances early detection and intervention in cardio-oncology. Future efforts should address the impact of AI technologies on clinical outcomes, and ethical challenges, to enable broader clinical adoption and improve patient care.
Curr Cardiol Rep
· 2025 Feb · PMID 39954172
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PURPOSE OF REVIEW: This article outlines updates in point of care ultrasonography. RECENT FINDINGS: Improving diagnostic accuracy and image quality is continuing to evolve in Point-of-care ultrasonography (POCUS). This i...PURPOSE OF REVIEW: This article outlines updates in point of care ultrasonography. RECENT FINDINGS: Improving diagnostic accuracy and image quality is continuing to evolve in Point-of-care ultrasonography (POCUS). This include incorporating Artificial Intelligence (AI) and use of other modalities such as Doppler in lung ultrasonography. Transesophageal echocardiography is an emerging option when imaging is difficult to obtain via transthoracic echocardiography. POCUS is becoming instrumental when used during cardiac arrest. Ultrasound (VExUS) Grading System is a promising measurement to assess a patient's volume status. Given the multiple advantages of POCUS usage, competency in POCUS became a requirement of Critical Care fellowship training. POCUS is an important diagnostic modality and guide to medical management. New technological advances such as AI, can serve as a guide to enhance image quality and help accurately obtain quantitative assessments. POCUS has a major role during cardiac arrest and advanced cardiac life support. The clinical utility of POCUS was further substantiated during the COVID-19 pandemic. The Accreditation Council for Graduate Medical Education (ACGME) requires critical care programs to include competency in POCUS as part of their training.
PURPOSE OF REVIEW: To explore the role of optimal cardiovascular health as defined by the Life's Essential 8 in breast cancer survivors. RECENT FINDINGS: Optimal cardiovascular health may be associated with decreased can...PURPOSE OF REVIEW: To explore the role of optimal cardiovascular health as defined by the Life's Essential 8 in breast cancer survivors. RECENT FINDINGS: Optimal cardiovascular health may be associated with decreased cancer mortality. Breast cancer survivors may derive additional benefit from obtaining ideal cardiovascular health as defined by the Life's Essential 8. Certain components of the Life's Essential 8 may impact cardiovascular risk but also cancer mortality, and risk for cancer therapy related cardiac dysfunction. Continued physical activity, avoidance of smoking, and control of lipids and blood pressure are beneficial in breast cancer survivors. More study is needed to define the role of anti-hyperglycemic agents, BMI, and sleep on CVD risk in breast cancer survivors. The Life's Essential 8 can be a tool to inform clinicians regarding a breast cancer survivor's disease risk and to identify potential areas of improvement.
PURPOSE OF REVIEW: This review evaluates the interplay between lipoprotein(a) [Lp(a)] and coronary artery calcium (CAC) for risk prediction and preventive therapy selection, with a special emphasis on scenarios where the...PURPOSE OF REVIEW: This review evaluates the interplay between lipoprotein(a) [Lp(a)] and coronary artery calcium (CAC) for risk prediction and preventive therapy selection, with a special emphasis on scenarios where these measures are discordant, particularly in otherwise intermediate-risk, primary prevention patients. RECENT FINDINGS: Observational studies and meta-analyses indicate a nuanced relationship between elevated Lp(a) levels and CAC burden and progression. Elevated Lp(a) is associated with an increased risk of CAC presence and progression; although, there is notable variability across studies. CAC predicts a similarly elevated risk in patients with low and high Lp(a). Joint elevation of Lp(a) and CAC is associated with a very high-risk patient subset. Elevated Lp(a) should prompt consideration of CAC testing for further risk stratification. In the future, we anticipate that an elevated CAC score could prompt consideration of testing for Lp(a) in select patients, as identifying or confirming elevated Lp(a) may help guide the use of dedicated Lp(a)-lowering therapies in very high-risk primary prevention populations.
Erbay MI, Manubolu VS, Stein-Merlob AF
… +6 more, Ferencik M, Mamas MA, Lopez-Mattei J, Baldassarre LA, Budoff MJ, Yang EH
Curr Cardiol Rep
· 2025 Feb · PMID 39932640
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PURPOSE OF REVIEW: Cardiovascular computed tomography (CCT) is a versatile, readily available, and non-invasive imaging tool with high-resolution capabilities in many cardiovascular diseases (CVD). Our review explains th...PURPOSE OF REVIEW: Cardiovascular computed tomography (CCT) is a versatile, readily available, and non-invasive imaging tool with high-resolution capabilities in many cardiovascular diseases (CVD). Our review explains the increased risk of CVD among patients with cancer due to chemoradiotherapies, shared risk factors and cancer itself and explores the expanding role of CCT in the detection, surveillance, and management of numerous CVD among these patients. RECENT FINDINGS: Recent research has highlighted the versatility and enhanced resolution capabilities of CCT in assessing a wide range of cardiovascular diseases. Early detection of cardiac changes and monitoring of disease progression in asymptomatic patients with cancer may lessen the severity of CVD. It offers an essential means to assess for coronary artery disease when patients are either unable to safely undergo stress testing for ischemia evaluation or at risk of complications from invasive coronary angiography. Furthermore, CCT extends its utility to valvular diseases, cardiomyopathies, pericardial diseases, cardiac masses, and radiation-induced cardiovascular diseases, allowing for a comprehensive, noninvasive assessment of the entire spectrum of cancer treatment associated CVD. Looking to the future, the integration of artificial intelligence and machine learning algorithms holds potential for automated image interpretation, improved precision and earlier detection of subclinical cardiac deterioration, allowing opportunities for earlier intervention and disease prevention. CCT is a useful imaging modality for assessing the myriad cardiovascular manifestations of diseases such as coronary artery disease, cardiomyopathies, pericardial disesaes, cardiac masses and radiation-induced cardiovascular diseases. CCT has several advantages. Readily available non-cardiac chest CT scans of patients with cancer may help with improved cardiovascular care, enhanced ASCVD risk stratification and toxicity surveillance.
Spadafora L, Quarta R, Martino G
… +7 more, Romano L, Greco F, Curcio A, Gori T, Spaccarotella C, Indolfi C, Polimeni A
Curr Cardiol Rep
· 2025 Feb · PMID 39932602
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PURPOSE OF REVIEW: Drug-eluting stent (DES) technology has greatly enhanced the safety and effectiveness of percutaneous coronary interventions (PCI). The aim of the present paper is to provide a comprehensive review of...PURPOSE OF REVIEW: Drug-eluting stent (DES) technology has greatly enhanced the safety and effectiveness of percutaneous coronary interventions (PCI). The aim of the present paper is to provide a comprehensive review of in-stent restenosis (ISR), focusing on the contemporary DES era, including its incidence, mechanisms, and imaging characterization. RECENT FINDINGS: Despite the widespread use of DES and numerous improvements, recent clinical data indicate that ISR still occurs in 5-10% of PCI procedures, posing a considerable public health issue. The incidence, morphology, and clinical implications of ISR are determined by a complex interplay of several factors: the patient, stent, procedure, and vessel and lesion-related factors. Advancements in intracoronary imaging have provided greater insight into its patterns and underlying causes. Over time, treatment strategies have evolved, and current guidelines recommend an individualized approach using intracoronary imaging to characterize ISR's underlying substrate.
PURPOSE OF REVIEW: Prosthesis-patient mismatch (PPM) remains a significant concern in valve intervention. This review highlights the current evidence surrounding PPM, compares its impact after surgical aortic valve repla...PURPOSE OF REVIEW: Prosthesis-patient mismatch (PPM) remains a significant concern in valve intervention. This review highlights the current evidence surrounding PPM, compares its impact after surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI), and addresses ongoing debates in the literature regarding valve selection, procedural strategies, and future approaches to improve patient outcomes. RECENT FINDINGS: Recent evidence highlights that moderate to severe PPM is associated with increased mortality and adverse cardiac events, particularly in younger, active patients and those with smaller aortic annuli. Studies have emphasized the role of optimized prosthesis sizing, advanced imaging modalities, and next-generation valve technologies in mitigating PPM. Additionally, TAVI appears to outperform surgical approaches in reducing severe PPM, particularly in high-risk populations. Despite significant progress, PPM remains a persistent challenge in valve intervention procedures, particularly among patients with smaller aortic annuli and those at risk for suboptimal hemodynamic performance. Addressing this issue requires continued innovation in prosthesis design, including valves with improved hemodynamic profiles and more sizing options. Long-term research is essential to better understand the clinical impact of PPM, evaluate valve durability across various types, and develop strategies to prevent its occurrence.
Allen TS, Najem M, Wood AC
… +4 more, Lee DJ, Pacheco LS, Daniels LB, Allison MA
Curr Cardiol Rep
· 2025 Feb · PMID 39928063
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PURPOSE OF REVIEW: Hypertension (HTN) is a major risk factor for cardiovascular diseases (CVD). The global prevalence of HTN and related CVD mortality continues to rise. The development of HTN is influenced by genetic pr...PURPOSE OF REVIEW: Hypertension (HTN) is a major risk factor for cardiovascular diseases (CVD). The global prevalence of HTN and related CVD mortality continues to rise. The development of HTN is influenced by genetic predisposition and modifiable risk factors, including diet. One area of ongoing debate is the relationship between red meat consumption and risk of HTN. RECENT FINDINGS: Processed red meat has become increasingly implicated in the pathogenesis and morbidity of HTN, though randomized control trials comparing HTN-related outcomes associated with red meat subtypes have yielded heterogenous results. This review summarizes the existing relevant literature and highlights the methodological challenges that complicate definitive conclusions, with a focus on processed versus unprocessed red meat consumption and HTN. It explores pathophysiologic mechanisms contributing to this relationship and reviews practical, evidence-based dietary guidelines that address red meat consumption to mitigate the risk of adverse HTN-related CVD outcomes.
PURPOSE OF REVIEW: Our goal of this review is to describe the current evidence and future applications of virtual reality (VR) from echocardiographic acquired images to enhance diagnostic accuracy and improve the visuali...PURPOSE OF REVIEW: Our goal of this review is to describe the current evidence and future applications of virtual reality (VR) from echocardiographic acquired images to enhance diagnostic accuracy and improve the visualization of cardiac structures by providing immersive 3-dimensional (3D) environments for better interpretation, communication between healthcare providers, families and trainees. RECENT FINDINGS: Virtual reality is a powerful tool for education, procedural planning and simulation. Using readily available echocardiographic images for this purpose is feasible, effective and safe. This document highlights the increasing role of VR in procedural planning, education, and intraprocedural guidance using three-dimensional echocardiography (3DE). Key advancements include the development of smaller 3D transthoracic and pediatric transesophageal probes with better temporal resolution, which enable enhanced imaging for preoperative planning. VR allows surgeons to visualize dynamic 3D cardiac models created from echocardiographic or Computed Tomography (CT) data, enabling better pre-surgical rehearsal, device selection, and landing zone visualization. It also provides immersive training tools for echocardiographers and offers potential for intraprocedural guidance in interventions such as atrial septal defect closures. These developments underscore the growing synergy between VR and 3DE for refining diagnosis and procedural strategies.
Sharma Y, Veneros DL, Pardee L
… +1 more, Caceres BA
Curr Cardiol Rep
· 2025 Feb · PMID 39918629
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PURPOSE OF REVIEW: This review summarizes recent evidence linking experiences of discrimination and anticipated discrimination with cardiovascular health outcomes. RECENT FINDINGS: Experiences of discrimination were cons...PURPOSE OF REVIEW: This review summarizes recent evidence linking experiences of discrimination and anticipated discrimination with cardiovascular health outcomes. RECENT FINDINGS: Experiences of discrimination were consistently associated with increased risk of nicotine exposure, poor sleep health, obesity, diabetes, hypertension, and subclinical cardiovascular disease. Evidence is mixed for cardiovascular disease diagnoses and cardiovascular mortality. Although research is limited, anticipated discrimination is an independent risk factor for poor sleep health and subclinical cardiovascular disease. Key methodological limitations included the limited use of gold-standard objective measures of health behaviors and well-validated self-report measures, inadequate consideration of intersectionality, and lack of robust examinations of psychological, behavioral, and physiological mechanisms linking discrimination with cardiovascular health outcomes. There is substantial evidence linking experiences of discrimination with cardiovascular outcomes. Yet, before translating these findings into clinical practice, more rigorous studies are needed to address methodological limitations and uncover mechanisms by which discrimination influences cardiovascular health. There is a need for studies to inform the development of evidence-based interventions focused on reducing the influence of discrimination-related stressors on cardiovascular health outcomes. Findings have important implications for future work to advance cardiovascular health equity.
PURPOSE OF REVIEW: To provide an overview of the predictive value of A Body Shape Index (ABSI) for the risk of cardiovascular events. RECENT FINDINGS: ABSI has been reported to have an association with development of car...PURPOSE OF REVIEW: To provide an overview of the predictive value of A Body Shape Index (ABSI) for the risk of cardiovascular events. RECENT FINDINGS: ABSI has been reported to have an association with development of cardiovascular diseases, and its usefulness for predicting major cardiovascular events including cardiovascular mortality, nonfatal coronary syndrome and nonfatal stroke has been investigated. The formula for ABSI includes waist circumference, which is not included in the conventional calculation of body mass index (BMI), along with BMI and height. High ABSI is independently associated with a high incidence of cardiovascular events. ABSI with specific cutoff values can be a useful tool for cardiovascular risk stratification by detecting the presence of abdominal obesity and it can be used for evaluation of the risk of cardiovascular events. Nonetheless, other factors such as race, gender, age, and physical, environmental and socioeconomic purviews also need be taken into consideration.
Curr Cardiol Rep
· 2025 Feb · PMID 39891819
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PURPOSE OF REVIEW: This review discusses the transformative potential of artificial intelligence (AI) in ischemic heart disease (IHD) prevention. It explores advancements of AI in predictive modeling, biomarker discovery...PURPOSE OF REVIEW: This review discusses the transformative potential of artificial intelligence (AI) in ischemic heart disease (IHD) prevention. It explores advancements of AI in predictive modeling, biomarker discovery, and cardiovascular imaging. Finally, considerations for clinical integration of AI into preventive cardiology workflows are reviewed. RECENT FINDINGS: AI-driven tools, including machine learning (ML) models, have greatly enhanced IHD risk prediction by integrating multimodal data from clinical sources, patient-generated inputs, biomarkers, and imaging. Applications in these various data sources have demonstrated superior diagnostic accuracy compared to traditional methods. However, ensuring algorithm fairness, mitigating biases, enhancing explainability, and addressing ethical concerns remain critical for successful deployment. Emerging technologies like federated learning and explainable AI are fostering more robust, scalable, and equitable adoption. AI holds promise in reshaping preventive cardiology workflows, offering more precise risk assessment and personalized care. Addressing barriers related to equity, transparency, and stakeholder engagement is key for seamless clinical integration and sustainable, lasting improvements in cardiovascular care.
Ziada K, Alkhawam H, Hajeh H
… +2 more, Modi M, Helmy T
Curr Cardiol Rep
· 2025 Jan · PMID 39883289
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PURPOSE OF REVIEW: What is the pathophysiology and clinical findings as well as management of patients presenting with INOCA/MINOCA (Ischemia/Myocardial Infarction with Non-Obstructive Coronary Arteries). RECENT FINDINGS...PURPOSE OF REVIEW: What is the pathophysiology and clinical findings as well as management of patients presenting with INOCA/MINOCA (Ischemia/Myocardial Infarction with Non-Obstructive Coronary Arteries). RECENT FINDINGS: INOCA/MINOCA has a complex pathophysiology. In this review article, we aim to summarize the complex pathophysiology and clinical diagnosis, and review the current management options.
PURPOSE OF REVIEW: We aim to summarize the available literature guiding tailored sedation practices for specific conditions encountered in the Cardiovascular Intensive Care Unit (CICU). RECENT FINDINGS: Data specific for...PURPOSE OF REVIEW: We aim to summarize the available literature guiding tailored sedation practices for specific conditions encountered in the Cardiovascular Intensive Care Unit (CICU). RECENT FINDINGS: Data specific for the CICU population is lacking. Preclinical data and observational studies guide sedation approaches for specific pathologies that we have used to generate a guideline for sedative choice for various scenarios. We discuss the challenges associated with extubation and highlight the importance of spontaneous breathing trials and role of non invasive ventilation. Understanding the underlying pathology and the effects of sedation and positive pressure ventilation is the base to guide induction and sedation management for patients in the CICU. There is a pressing need for further research to generate high quality clinical data to improve sedation techniques in the CICU.
Spetko N, Oribabor J, Anyanwu E
… +4 more, Tyler TBI, Rodriguez DF, Ouyang D, Strom JB
Curr Cardiol Rep
· 2025 Jan · PMID 39878798
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PURPOSE OF REVIEW: To provide a contemporary update on the American Society of Echocardiography's ImageGuideEcho Registry and present a case study of an individual institution's experience with enrollment. RECENT FINDING...PURPOSE OF REVIEW: To provide a contemporary update on the American Society of Echocardiography's ImageGuideEcho Registry and present a case study of an individual institution's experience with enrollment. RECENT FINDINGS: Technical innovation in clinical echocardiography has expanded the impact of echocardiography in cardiovascular care and provides new opportunities to leverage clinical data to inform quality improvement initiatives and research. The ImageGuideEcho Registry is the first echocardiography-specific imaging registry in the United States and provides a data infrastructure for quality improvement and multicenter research. The ImageGuideEcho Registry continues to grow, offering a window into echocardiography care across the United States in a variety of practice settings. This early experience highlights its value, opportunities, and ongoing challenges. Continued innovation, such as the addition of primary images, will further add to the substantial value of the registry.
PURPOSE OF REVIEW: This review aims to explore how a diagnosis of LMNA-related cardiomyopathy (LMNA-CM) informs clinical management, focusing on the prevention and management of its complications, through practical clini...PURPOSE OF REVIEW: This review aims to explore how a diagnosis of LMNA-related cardiomyopathy (LMNA-CM) informs clinical management, focusing on the prevention and management of its complications, through practical clinical strategies. RECENT FINDINGS: Longitudinal studies have enhanced our understanding of the natural history of LMNA-CM including its arrhythmic and non-arrhythmic complications. A LMNA specific ventricular arrhythmia risk prediction strategy has been integrated into clinical practice guidelines. Although less robust, observational studies are shaping gene-specific strategies for mitigating other complications including atrioventricular block, atrial fibrillation and cardiomyopathy, while novel therapies have been evaluated in clinical trials. LMNA-CM follows an aggressive yet generally stereotyped course. Early recognition of anticipated complications allows for more effective prevention and management in both symptomatic and asymptomatic patients.
PURPOSE OF THE REVIEW: Takotsubo syndrome (TTS) is a transient form of left ventricular dysfunction, typically affecting post-menopausal females, often preceded by emotional or physical stressful events that act as trigg...PURPOSE OF THE REVIEW: Takotsubo syndrome (TTS) is a transient form of left ventricular dysfunction, typically affecting post-menopausal females, often preceded by emotional or physical stressful events that act as triggers. Initially believed to be a rare and benign condition for its reversible nature, TTS has recently emerged as a complex multifaceted clinical entity, with heterogenous clinical presentations and a non-negligible risk of serious in-hospital complications, including acute heart failure, arrhythmias and death. RECENT FINDINGS: Emerging pathophysiological hypotheses, ranging from microvascular dysfunction to systemic inflammation, offer new insights into the underlying mechanisms of TTS. Moreover, increasing awareness of potential complications during the acute phase of the disease underscores its significant prognostic implications and emphasizes the need for randomized clinical trials to guide the therapeutic management of TTS. In this narrative review article, we aim to discuss the recent insights on the epidemiology, pathophysiology, treatment and prognosis of patients affected by TTS discussing the emerging evidence and the remaining knowledge gap in the field.