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Takotsubo cardiomyopathy. This is a rare ACS mimic and nearly impossible to differentiate from the real deal - ACS - in the emergency department prior to cath. Criteria for diagnosis include absence of obstructive coronary disease, transient left ventricular apical akinesis and new EKG abnormalities in the absence of another cause (head trauma, myocarditis, hypertrophic cardiomyopathy, etc). Patients, with a preponderance females, often present after emotional or physical stress. Pathophysiology is unclear. Outcome is generally favorable with cardiac hypocontractility usually resolving in 2 - 4 weeks.
Source
Barker, S. et al. "Electrocardiographic ST-segment elevation: Takotsubo cardiomyopathy versus ST-segment elevation myocardial infarction - A case series" American Journal of Emergency Medicine. 2009.