Takotsubo in Acute and Chronic Coronary Artery Disease

Cardiomyopathy of Takotsubo syndrome (TS) is typically triggered by an emotional stress in postmenopausal women. Coexistent coronary artery disease presents diagnostic dilemmas in patients with TS, as seen in the 2 cases presented. In the first case, acute coronary syndrome acts as a physical trigger for TS when a middle-aged man presents with an inferior myocardial infarct, and in the second case, coronary artery disease is a bystander when an elderly woman develops TS after a fall and facial trauma. The novel teaching point is that acute non–left anterior descending acute coronary syndrome could trigger TS.