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Takotsubo cardiomyopathy presenting as acute coronary syndrome — SCE Acute Medicine MCQ

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HardCardiovascular medicineTakotsubo cardiomyopathy presenting as acute coronary syndromeSCE Acute Medicine

After intense emotional stress, a patient has anterior ST elevation and apical ballooning, but unobstructed coronary arteries. What is the safest immediate diagnostic-management framing?

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Correct answer: B — Treat as ACS during diagnostic clarification

The best answer is “Treat as ACS during diagnostic clarification”. This is correct because Takotsubo commonly mimics infarction and cannot be safely distinguished before coronary assessment. Subsequent echocardiography or cardiac MRI defines recovery and excludes myocarditis or infarction. Emotional stress is supportive but not diagnostic, and complications such as shock, arrhythmia and thrombus require monitoring.

Reference: International Expert Consensus on Takotsubo syndrome: https://academic.oup.com/eurheartj/article/39/22/2032/5025412