Takotsubo Syndrome: A Myocardial Mimic

Takotsubo syndrome is identified by the European Society of Cardiology as an acute reversible heart failure syndrome.¹  This syndrome is characterized by an acute regional dysfunction of the left ventricle in the absence of obstructive coronary artery disease. Most importantly, the regional wall motion abnormality is transient. When viewed during diagnostic testing, the left ventricle of a person with Takotsubo syndrome shows ballooning of the cardiac apex (apical ballooning) with a hypercontractile ventricular base during systole (Figure 1).^1–4  Patients present with chest pain and electrocardiogram (ECG) abnormalities mimicking an acute myocardial infarction (MI).¹  Most often the ECG presentation is that of an anterior wall ST elevation myocardial infarction (STEMI), but patients may also present with deep T-wave inversions as in a non-STEMI.^5–7  On arrival to emergency departments, patients with cardiac symptoms and ECG findings of an acute anterior wall MI...