A Case of Acute ST-Segment Elevation Myocardial Infarction Mimicking Stress Induced Cardiomyopathy; Demonstration of Typical Echocardiographic Finding Correlated with Unusual Distribution of Left Anterior Descending Coronary Artery

Stress-induced cardiomyopathy (SCMP), also known as Tako-tsubo cardiomyopathy, was first described by Dote et al. 1) in 1991. Initially, it is known as a clinical syndrome characterized by chest pain following emotional or physical stress, a typical ST-segment elevation on electrocardiography (ECG), mild increase in cardiac enzymes, and reversible left ventricular dysfunction with characteristic apical ballooning in patients without significant epicardial coronary artery stenosis. 2)3) Recently, there are several variation of SCMP involving mid portion, basal portion or both portions of the left ventricle (basal ballooning syndrome). ecause SCMP shows similar clinical presentation with acute ST-segment elevation myocardial infarction (STEMI), SCMP can be misdiagnosed as an acute STEMI. However, it can be fatal if with misdiagnosis of acute STEMI as an SCMP. Here, we report a case with acute STEMI with typical echocardiographic feature of SCMP as a result of anatomical variation of the left anterior descending coronary artery (LAD). In this patient, early coronary angiography was very necessary.