Takotsubo syndrome without major stress mimicking myocarditis

Heart Failure Association of the European Society of Cardiology defines Takotsubo syndrome as the transient regional wall motion abnormalities occurring in the ventricles, which are incompatible with a single coronary artery distribution apart from new and reversible changes depicted in the electrocardiogram (ECG). It is frequently associated with stressful triggers, considerable elevation of natriuretic peptide, and usually small changes in cardiac troponin. Evidence of ventricular systolic function recovery on cardiac imaging should be present at the follow-up to confirm its diagnosis and treatment (1). Myocarditis and acute coronary syndrome are the two major differential diagnoses of Takotsubo syndrome. The objective of this report is to present a case of Takotsubo syndrome with myocarditis or acute coronary syndrome features and without major stress