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Takotsubo cardiomyopathy — RACP Adult Medicine MCQ

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ModerateCardiologyTakotsubo cardiomyopathyRACP Adult Medicine

A 69-year-old woman develops chest pain after the sudden death of her spouse. ECG shows anterior T-wave inversion and troponin is mildly elevated. Coronary angiography shows no obstructive coronary disease, and ventriculography shows apical ballooning with basal hyperkinesis. What is the most likely diagnosis?

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Correct answer: B — Takotsubo cardiomyopathy

Emotional stress, modest troponin rise, unobstructed coronaries and apical ballooning are characteristic of Takotsubo cardiomyopathy. LAD occlusion would usually show culprit coronary obstruction. Pericarditis, hypertrophic cardiomyopathy and vasospasm do not explain the typical ventriculographic pattern.

Reference: National Heart Foundation of Australia/CSANZ ACS Guideline 2025; AMH