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Takotsubo Cardiomyopathy — RACP Adult Medicine MCQ

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EasyCardiologyTakotsubo CardiomyopathyRACP Adult Medicine

A 45-year-old woman presents with acute dyspnoea. Echocardiography shows LVEF 25% with apical ballooning and hyperkinesis of the basal segments. Coronary angiography is normal. She reports recent bereavement. What is the most likely diagnosis?

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Correct answer: C — Takotsubo cardiomyopathy

Takotsubo (stress) cardiomyopathy presents with acute heart failure or ACS-like symptoms, typically following emotional or physical stress. The classic pattern is apical ballooning with basal hyperkinesis on echocardiography, with normal coronary arteries. Troponin is mildly elevated. LV function usually recovers within weeks to months. Supportive management with avoidance of catecholamines is recommended. Complications include LVOT obstruction, cardiogenic shock, and LV thrombus.

Reference: eTG – 2025 – Cardiovascular; ESC – 2023 – Cardiomyopathies