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Stress cardiomyopathy (SCM) is a clinical phenomenon presenting symptoms suggestive of acute coronary syndrome and defined by acute, but transient, electrocardiogram (ECG) changes and left ventricular wall motion abnormalities. However, no obstructive coronary lesion is identified on catheterization, and pathognomic echocardiogram findings are typically encountered. Multiple causes have been posited in the literature (e.

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In clinical practice, dynamic left ventricular outflow tract obstruction (LVOTO) in the setting of tako-tsubo cardiomyopathy (TTC) has been regarded as an early-onset complication typically emerging in accordance with wall motion abnormalities. However, dynamic LVOTO has, very rarely, been reported as a late-onset phenomenon in the setting of TTC as well (arising in the late stage or after recovery). Accordingly, the present paper aims to highlight clinical relevance and potential implications of late-onset LVOTO in the setting of TTC.

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Tako-tsubo syndrome pertains to rare acquired cardiomyopathies, characterized by left ventricular dyskinesia and symptomatology typical for acute myocardial infarction (AMI). Despite its low incidence and relatively benign course, stress cardiomyopathy should be thoroughly differentiated from AMI. The importance of tako-tsubo consists of the fact that its manifestation initially resembles AMI.

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One heart, two cardiomyopathies.

BMJ Case Rep

June 2012

Department of Cardiology, Papworth Hospital, Cambridge, UK.

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