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Patient
64-year-old woman with chest pain 9 days earlier because of a street assault (wallet theft);
Trace
This tracing shows a sinus rhythm, a narrow QRS, an isolated Q-wave in lead II (minimal in aVF), a moderate depression in leads I, aVL and negative T-waves from V2 to V6 and in leads I and aVL; the negative T-waves are of high amplitude; the QT interval is prolonged (500 ms, QTc to 464 ms); isolated ventricular extrasystole;
Exergue
The electrocardiographic pattern of Takotsubo is dynamic and varies according to the delay in onset of symptoms with significant interindividual variations. It is very difficult from an ECG to differentiate between Takotsubo and an anterior acute coronary syndrome due to occlusion of the medial or distal LAD; performing a coronary angiography is essential to confirm the diagnosis.
This patient presents a Takotsubo's syndrome, evoked in conjunction with clinical context (postmenopausal woman, chest pain occurring as a result of a significant emotional stress, electrocardiographic pattern of diffuse negative T-waves with QT interval prolongation, slight increase in troponin