Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy or "broken heart syndrome," is a transient left ventricular systolic dysfunction typically precipitated by emotional or physical stress. It closely mimics acute coronary syndrome (ACS) but occurs in the absence of significant coronary artery obstruction. We present the case of a 73-year-old woman with a medical history of hypertension, diabetes mellitus, hyperlipidemia, and osteoporosis, who presented with sudden-onset chest pain radiating to the throat, left arm, shoulder, and neck, accompanied by nausea, vomiting, and diaphoresis. Initial evaluation revealed elevated high-sensitivity troponin and B-type natriuretic peptide (BNP) levels, along with electrocardiographic findings suggestive of Wellens syndrome. Emergent coronary angiography demonstrated only minimal atherosclerotic disease. Left ventriculography revealed apical akinesis with basal hyperkinesis, consistent with TCM; an apical thrombus was also identified. The patient was managed with anticoagulation and supportive medical therapy. This case underscores the importance of considering TCM in elderly female patients presenting with ACS-like symptoms, particularly when coronary angiography does not reveal significant obstructive lesions. Keywords: Takotsubo cardiomyopathy, stress-induced cardiomyopathy, acute coronary syndrome, Wellens syndrome, apical thrombus.
González et al. (Wed,) studied this question.