Misleading takotsubo-like syndrome unravelled by intracoronary imaging

A 58-year-old female with not relevant medical history presented with chest pain few hours after an emotional distress (death of a relative). Electrocardiogram showed wide positive anterior T waves that became negative after symptoms relief following nitrate administration (Panel A). A bedside transthoracic echocardiogram showed apical left ventricular (LV) akinesia. Coronary angiography was performed, revealing a mild, smooth contour stenosis in mid left anterior descending artery (LAD) not affecting antegrade flow (Panel B, circle). Ventriculography was concordant with echocardiogram findings (Panel C).

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