Takotsubo Cardiomyopathy

Key points

• Also known as 'broken heart syndrome' and Takotsubo apical ballooning syndrome — a cardiomyopathy induced by severe stressful triggers (e.g. emotional upset/bereavement); commoner in women.
• Mimics STEMI (ST-segment elevation, slightly raised troponin) but invasive angiography shows no luminal obstruction.
• Takotsubo is Japanese for octopus trap: apical ballooning on left ventriculogram/CMR/echo due to severe hypokinesis of the mid and apical segments with preserved basal contraction.
• Causes of ST elevation: MI · pericarditis/myocarditis · normal variant 'high take-off' · LV aneurysm · Prinzmetal's angina (coronary spasm) · Takotsubo cardiomyopathy · rarely subarachnoid haemorrhage.