A 51-year-old woman, with a history of acute myocardial infarction (percutaneous intervention of left anterior descending [LAD] coronary artery) was admitted to the coronary care unit for chest pain and cardiogenic shock following tragic news. The electrocardiogram demonstrated sinus rhythm and a known complete left bundle branch block. Coronary angiography was performed immediately, revealing no significant coronary lesions. Left ventricular (LV) angiography found LV regional wall motion abnormalities extending beyond a single epicardial coronary distribution (LV ejection fraction, 25%) and was suggestive of Tako-Tsubo cardiomyopathy ( Fig. 1 A , Appendix A Video 1). The diagnosis of coronary spasm was excluded because the pattern of LV systolic dysfunction did not correspond to a specific coronary territory. Transthoracic echocardiography confirmed LV systolic dysfunction, without any LV outflow tract obstruction. Peak plasma creatinine kinase and troponin I concentrations were 203 IU/L and 1.86 μg/L, respectively. An inotropic agent was infused over 24 hours and the patient was discharged from the hospital on day nine.
