Takotsubo - The great pretender

This article describes how takotsubo syndrome was misdiagnosed as other diagnoses prior to its being named in 1990.

Given our present understanding of the clinical, echocardiographic, and angiographic features of takotsubo, the modern literature from about 1970 to the present was reviewed to find other cardiac conditions consistent with the takotsubo diagnosis. Nine conditions were recognized, including 6 that have been previously reported. These include some patients with either STEMI, NSTEMI, MINOCA, cerebral T-waves, sepsis-related LV dysfunction, or stress-related cardiomyopathy. Three other conditions have not previous been reported and include some patients with either non-obstructive or angiographically normal coronary arteries following IV thrombolytic therapy, myocarditis mimicking acute myocardial infarction, or myocardial stunning.

Takotsubo syndrome has been a great pretender, mimicking or misdiagnosed as several other cardiac conditions. Some of these conditions have been previously reported, while others are newly described. It is intriguing to speculate what signs or symptoms of a present-day illness/ailment may, in the future, represent other conditions currently unclassified or misdiagnosed.