Fig. 5.

ECG TCM. ECG in a 60 year old female with respiratory distress due to acute exacerbation of COPD. An acute anterior myocardial infarction is suspected because of the ST elevation in anteroseptal leads (V1-V4), T wave inversion in inferolateral leads (II, III, aVF, V5-V6) and her worrisome respiratory condition. However, the urgent coronary angiography does not reveal any significant coronary stenosis. The diagnosis of a takotsubo cardiomyopathy is made based on the diffuse akinesia of the mid-ventricular segments, apical dilatation and hyperdynamic contractility of the basal segments, as seen on the echocardiography after the catheterization. After successful treatment of her respiratory problem, left ventricular systolic function has fully recovered.