Takotsubo syndrome (TTS) is a reversible condition of abnormal myocardial contraction that was first given this name in Japan by Dr. Sato in 1991. The name comes from the Japanese word for “octopus trap,” which has a similar shape to that of the left ventricle on ventriculography during Takotsubo syndrome. It is also known as broken heart syndrome, stress-induced cardiomyopathy, or apical ballooning syndrome. The first descriptions of this phenomenon date as far back as the 1960s.

TTS typically presents with symptoms and clinical signs suggestive of acute coronary syndrome (ACS). It may include ST segment elevations on electrocardiogram (ECG) characteristic of acute ischemia even though the syndrome is not caused by direct myocardial ischemia. On echocardiography, TTS is usually characterized by segmental wall motion abnormalities (SWMA) with hyperdynamic contraction of the left ventricular basal walls and akinesis of the apical walls. This results in the “apical ballooning” and is notably not in the distribution of typical coronary artery anatomy. Traditionally, the diagnosis of TTS involves the aforementioned findings and coronary angiography showing no obstructive coronary artery disease (CAD). We present here a case of an acute lateral ST-elevation myocardial infarction (STEMI) with subsequent cardiogenic shock due to TTS.