TTC: Takotsubo cardiomyopathy; COPD: chronic obstructive pulmonary disease. P values from chi-square test (categorical) or t-test (continuous). P values are two-sided; P < 0.05 is considered statistically significant.
During the preparation of this work, the authors used ChatGPT (OpenAI) to assist with wording/clarity and figure concept rendering. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.
Author contributions
ID: Conceptualization, Methodology, Formal analysis, Writing—original draft, Visualization. PC: Data curation, Formal analysis, Writing—original draft, Writing—review & editing. GKS: Supervision, Methodology, Validation, Writing—review & editing. NLW: Supervision, Methodology, Validation, Writing—review & editing. All authors read and approved the submitted version.
Conflicts of interest
The author declares that there are no conflicts of interest.
Ethical approval
This study utilized de-identified, publicly available data from the 2022 National Inpatient Sample (NIS), a component of the Healthcare Cost and Utilization Project (HCUP). As the dataset contains no individually identifiable information and was accessed in accordance with HCUP data use requirements, this study was exempt from institutional review board (IRB) review under 45 CFR 46.101(b).
Consent to participate
The requirement for informed consent was waived as this study utilized de-identified, publicly available data from the National Inpatient Sample (NIS) and met criteria for exemption under 45 CFR 46.101(b).
Consent to publication
Not applicable.
Availability of data and materials
The data analyzed in this study were obtained from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (https://www.hcup-us.ahrq.gov/). Requests for access should be directed to HCUP.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Komamura K, Fukui M, Iwasaku T, Hirotani S, Masuyama T. Takotsubo cardiomyopathy: Pathophysiology, diagnosis and treatment.World J Cardiol. 2014;6:602–9. [DOI] [PubMed] [PMC]
Amin HZ, Amin LZ, Pradipta A. Takotsubo Cardiomyopathy: A Brief Review.J Med Life. 2020;13:3–7. [DOI] [PubMed] [PMC]
Yoshikawa T. Takotsubo cardiomyopathy, a new concept of cardiomyopathy: Clinical features and pathophysiology.Int J Cardiol. 2015;182:297–303. [DOI] [PubMed]
Merchant EE, Johnson SW, Nguyen P, Kang C, Mallon WK. Takotsubo cardiomyopathy: a case series and review of the literature.West J Emerg Med. 2008;9:104–11.
Auzel O, Mustafic H, Pillière R, El Mahmoud R, Dubourg O, Mansencal N. Incidence, Characteristics, Risk Factors, and Outcomes of Takotsubo Cardiomyopathy With and Without Ventricular Arrhythmia.Am J Cardiol. 2016;117:1242–51. [DOI] [PubMed]
Lin W, Tay SH, Mak A. Takotsubo syndrome and rheumatic diseases—a critical systematic review.Rheumatology. 2020;60:11–22. [DOI] [PubMed]
Angelini P, Uribe C, Tobis JM. Pathophysiology of Takotsubo Cardiomyopathy: Reopened Debate.Tex Heart Inst J. 2021;48:e48. [DOI] [PubMed] [PMC]
Clauw DJ. Fibromyalgia: An Overview.Am J Med. 2009;122:S3–13. [DOI] [PubMed]
Györfi M, Rupp A, Abd-Elsayed A. Fibromyalgia Pathophysiology.Biomedicines. 2022;10:3070. [DOI] [PubMed] [PMC]
AlKowatli H, Alkowatli O, Karzoun A, Sawaf B, Habib MB, Bansal N, et al. Recurrent Takotsubo Cardiomyopathy With Variable Patterns and Psychiatric Comorbidities: A Case Report and Comprehensive Literature Review.Clin Case Rep. 2025;13:e70635. [DOI] [PubMed] [PMC]
Ezaldin S, Abdelsalam MG, Nease SM. Takotsubo’s return: when autoimmunity strikes twice.J Am Coll Cardiol. 2024;83:3536. [DOI]
Aldarwesh A. Journey of Hope for Patients with Fibromyalgia: From Diagnosis to Self-Management—A Qualitative Study.Healthcare. 2025;13:142. [DOI] [PubMed] [PMC]
Davidoff TQ. Atypical chest pain in a fibromyalgia patient presenting to urgent care.J Urgent Care Med. 2019;14:17–9.
Doebl S, Macfarlane GJ, Hollick RJ. No one wants to look after the fibro patient”. Understanding models, and patient perspectives, of care for fibromyalgia: reviews of current evidence.Pain. 2020;161:1716–25. [DOI] [PubMed]
Kachaner A, Harim M, Combier A, Trouvin AP, Avouac J, Ranque B, et al. Management perspectives from patients with fibromyalgia experiences with the healthcare pathway: a qualitative study.Front Med. 2023;10:1231951. [DOI] [PubMed] [PMC]
Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy.N Engl J Med. 2015;373:929–38. [DOI]
Wittstein IS. Why Age Matters in Takotsubo Syndrome.J Am Coll Cardiol. 2020;75:1878–81. [DOI] [PubMed]
El-Battrawy I, Santoro F, Núñez-Gil IJ, Pätz T, Arcari L, Abumayyaleh M, et al. Age‐Related Differences in Takotsubo Syndrome: Results From the Multicenter GEIST Registry.J Am Heart Assoc. 2024;13:e030623. [DOI] [PubMed] [PMC]
Martinez-Lavin M. Fibromyalgia as a sympathetically maintained pain syndrome.Curr Pain Headache Rep. 2004;8:385–9. [DOI] [PubMed]
Jensen KB, Kosek E, Petzke F, Carville S, Fransson P, Marcus H, et al. Evidence of dysfunctional pain inhibition in Fibromyalgia reflected in rACC during provoked pain.Pain. 2009;144:95–100. [DOI] [PubMed]
Ghadri JR, Wittstein IS, Prasad A, Sharkey S, Dote K, Akashi YJ, et al. International Expert Consensus Document on Takotsubo Syndrome (Part II): Diagnostic Workup, Outcome, and Management.Eur Heart J. 2018;39:2047–62. [DOI] [PubMed] [PMC]
Thiagarajah AS, Guymer EK, Leech M, Littlejohn GO. The relationship between fibromyalgia, stress and depression.Int J Clin Rheumatol. 2014;9:371–84. [DOI]