Key result
Electrocardiograms can identify edema-induced pseudohypertrophy in Takotsubo syndrome through the absence of left ventricular hypertrophy evidence and a transient reduction in QRS amplitude.
Transient attenuation and subsequent recovery of QRS amplitudes on serial ECGs can reliably exclude masquerading apical hypertrophic cardiomyopathy in patients presenting with Takotsubo syndrome complicated by pseudohypertrophy.
Some patients with takotsubo syndrome reveal transiently features of hypertrophic cardiomyopathy at imaging, particularly of the apical variety; this "pseudohypertrophy" is due to myocardial edema, and can be diagnosed by the absence of electrocardiogram evidence of left ventricular hypertrophy, and particularly a transient reduction of the amplitude of QRS complexes.
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John E. Madias (2026) studied this question. Electrocardiograms can identify edema-induced pseudohypertrophy in Takotsubo syndrome through the absence of left ventricular hypertrophy evidence and a transient reduction in QRS amplitude.
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