The diagnosis of Takotsubo cardiomyopathy is typically confirmed in the cardiac catheterization laboratory; as noted above, the absence of obstructive coronary artery disease on cardiac catheterization, in the presence of a ballooning wall-motion abnormality, is key to the diagnosis. Takotsubo cardiomyopathy cannot be reliably differentiated from STEMI solely on the basis of ECG findings. An initially normal or nonspecific ECG finding is seen in 15% of patients with Takotsubo cardiomyopathy. Diffuse T-wave inversions tend to occur in the days and weeks following presentation as the ST segments normalize.
In addition to evaluating wall-motion abnormalities and LVEF, cardiac MRI has been found to differentiate Takotsubo cardiomyopathy, which is characterized by the absence of delayed gadolinium hyperenhancement, from MI and myocarditis, in which the opposite occurs.
For more on the workup of Takotsubo cardiomyopathy, read here.
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Cite this: Yasmine S. Ali. Fast Five Quiz: How Much Do You Know About 'Broken-Heart Syndrome'? - Medscape - Jan 22, 2018.
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