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Takotsubo Cardiomyopathy — RACP Adult Medicine MCQ

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ModerateCardiologyTakotsubo CardiomyopathyRACP Adult Medicine

A 60-year-old postmenopausal woman presents to ED with acute chest pain and dyspnoea after receiving news of a family death. Troponin is 800 ng/L. ECG shows ST elevation in V1-V4. Urgent coronary angiography shows no obstructive coronary disease. Left ventriculography shows apical ballooning with hyperkinetic basal segments. What is the most likely cause?

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Correct answer: B — Takotsubo cardiomyopathy

Chest pain after emotional/physical stress in a postmenopausal woman with ST elevation, elevated troponin, normal coronaries, and apical ballooning (takotsubo/ampulla pattern) is takotsubo cardiomyopathy (stress cardiomyopathy). InterTAK diagnostic criteria apply. Catecholamine surge causes myocardial stunning. Most recover LVEF within 1-4 weeks. Complications: LV thrombus, outflow tract obstruction, cardiogenic shock (~5%).

Reference: ESC – 2024 – Takotsubo; InterTAK Diagnostic Score