Takotsubo Cardiomyopathy: a benign condition or a bad omen?

Takotsubo cardiomyopathy (TC), also known as “stress cardiomyopathy” or “broken heart syndrome,” is a transient disorder, typically following an acute emotional or physical stress, mimicking an acute coronary syndrome (ACS). Patients with TC complain of chest pain and show electrocardiogram dynamic changes such as ST-segment elevation or negative T waves with a mild increase in cardiac biomarkers and absence of significant coronary artery involvement. Left ventricular (LV) wall motion abnormalities in TC are typically akinesia or hypokinesia of apical segments (apical balloon-like dilation pattern) associated with hyperkinesia of the basal segments.1-3 Echocardiography plays a key role in the diagnosis, allowing direct visualization of the typical apical ballooning pattern, and it is considered specific. New technologies, such as speckle tracking echocardiography, are useful.4-7 Despite the fact that these findings are unlikely in ACS, coronary angiography is needed to rule out myocardial infarction.1-3