The Other Great Masquerader: Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy is a rare entity that mimics acute myocardial infarction or congestive heart failure. It is characterised by acute, transient, reversible left ventricular dysfunction that can mimic an acute coronary event at presentation. Coronary arteries are however, often normal on cardiac catheterisation. Patients are usually postmenopausal women who experience acute physical or emotional distress. For years this syndrome has been mistaken for acute myocardial infarction owing to a typical presentation with chest pain, electrocardiographic abnormalities, elevated cardiac enzymes and focal left ventricular wall motion abnormalities. Clinical diagnosis is difficult and demands a high index of suspicion. Recently proposed Mayo criteria might help in diagnosis. Delay in diagnosis should not result in delay in treatment. We report a case involving a post menopausal female who had an attack of takotsubo cardiomyopathy with a favourable outcome.