Takotsubo Syndrome in Coronavirus Disease 2019

Contraction bands in combination with mononuclear infiltration, argue against artifactual changes and is indicative of the acute phase of severe left ventricular dysfunction. [...]an earlier biopsy may reveal the true incidence of contraction band necrosis in cases of COVID-19 myocardial injury with impaired wall motion abnormalities and normal coronary arteries. In summary, the severe inflammatory response that occurs in COVID-19 may work in concert with the exaggerated sympathetic stimulation of TTS to activate similar pathways, resulting in severe microcirculatory dysfunction, global/regional myocardial edema, and decompensated acute heart failure. [...]patients with a dual diagnosis of TTS and COVID are at increased risk of adverse events.Disclosures The authors have no conflict of interest to disclose.