Distinguishing a heart attack from the "broken heart syndrome" (Takotsubo cardiomyopathy)

Takotsubo cardiomyopathy (TC) is a neurocardiological disorder presumed to be triggered by stress, which may cause reversible heart failure, usually in postmenopausal women. It may mimic an acute myocardial infarction, accompanied by minimal elevation of cardiac enzymes, usually without evidence of obstructive coronary artery disease. Most clinicians are unfamiliar with this disorder. Therefore, some TCs are misdiagnosed as acute myocardial infarction. The modified Mayo Clinic criteria usually confirm a diagnosis, although the diagnostic criteria for TC remain controversial. Enhanced awareness by clinicians is important when encountering patients with chest pain and elevated cardiac enzymes. Takotsubo cardiomyopathy is usually associated with a favorable prognosis, although in rare instances it may be associated with life-threatening complications. Supportive care is especially important in the TC management. Our aim was to describe TC, characterize its clinical features, and extensively review the relevant literature.