The provided UK guidelines do not specify diagnostic tests for confirming a diagnosis of Takotsubo cardiomyopathy in a primary care setting.
However, for individuals presenting with recent-onset chest pain of suspected cardiac origin, primary care assessment would typically involve taking a careful and detailed history, performing a clinical examination, and obtaining a resting 12-lead ECG NICE CG95. Changes on a resting 12-lead ECG, such as pathological Q waves, left bundle branch block (LBBB), or ST-segment and T-wave abnormalities, may indicate ischaemia or previous infarction NICE CG95.
If an acute coronary syndrome (ACS) is suspected, patients are usually referred to hospital where a resting 12-lead ECG and a blood sample for high-sensitivity troponin I or T measurement are taken on arrival NICE CG95. A raised troponin level, detected in people with a suspected ACS, requires reassessment to exclude other causes (for example, myocarditis, aortic dissection, or pulmonary embolism) before confirming the diagnosis of ACS NICE CG95. Takotsubo cardiomyopathy would fall under these 'other causes' that are typically differentiated in a secondary care setting.
For suspected heart failure, N-terminal pro-B-type natriuretic peptide (NT-proBNP) is measured, and depending on the level, urgent or specialist assessment and transthoracic echocardiography within 2 to 6 weeks are recommended NICE NG106.