The "broken heart sydrome": you're likely to have it only once!

Stress cardiomyopathy (SC) is also known as Takotsubo cardiomyopathy. The term transient left ventricular ballooning syndrome has also been used. These terms refer to the same phenomenon. The typical presentation of SC in a patient is a sudden onset of chest pain or heart failure associated with electrocardiographic changes of ST-segment elevation, which is suggestive of anterior ST-segment elevation myocardial infarction. When these patients are assessed, a bulging of the left ventricular apex with a hypercontractile base of the left ventricle is noted. It is this hallmark bulging of the apex with preserved function at the base that characterises this unique syndrome. The possible pathophysiology of its mechanism as well as the different morphological types are discussed.