The stress of chest pain: a case of tako-tsubo cardiomyopathy

Summary

Tako-tsubo cardiomyopathy is an important syndrome whose presentation mimics that of an acute coronary syndrome/myocardial infarction. It is a transient phenomenon characterised by chest pain, electrocardiographic changes, elevation of cardiac enzymes, apical/mid left ventricular ballooning and regional wall motion changes in the absence of significant angiographic coronary artery disease.

The present report concerns a case of tako-tsubo cardiomyopathy in a 62-year-old woman admitted following stressful events. The postulated pathogenesis, investigations and treatment of a syndrome whose clinical spectrum of severity ranges from that of stability to cardiogenic shock is discussed.

Since its initial description in the 1990s the syndrome has been increasingly diagnosed. Emotional and physical stress is thought to be an important predisposing factor. This syndrome demonstrates the importance of not underestimating the potential organic manifestations of stress as well as the necessity to ensure accurate collection of medical history when assessing patients.