title: An Emotional Stress as a Trigger for Reverse Takotsubo Cardiomyopathy: A Case Report and Literature Review.
abstract: BACKGROUND
  Reverse Takotsubo cardiomyopathy is one of the rarest types of stress-induced cardiomyopathy, which despite sharing similar pathogenic mechanisms with its more common counterpart, has different clinical manifestations, demographics, and laboratory values.
  
  
  METHODS
  We present the case of a 61-year-old woman who came to the hospital with a chief complaint of chest pain and dyspnea. She was found to have elevated troponin and severely depressed left ventricular function. Echocardiography showed normal contracting apex, with the rest of the left ventricle being hypokinetic. Cardiac catheterization revealed mild coronary artery disease and confirmed echocardiographic findings showing hyperkinetic apex and dilated base. She was discharged home on ACE inhibitor and B-blocker. A repeat echocardiogram 2 weeks after the initial presentation showed complete resolution of cardiac dysfunction.
  
  
  CONCLUSIONS
  Reverse Takotsubo cardiomyopathy is a rare disease mimicking acute coronary syndrome. It is essential to rule out organic coronary disease prior to attributing the presentation to Takotsubo cardiomyopathy. With supportive care, the long-term prognosis is good in the vast majority of patients.
authors.affiliation: Department of Internal Medicine, Hospital Sisters Health System - St. Mary's Hospital, Decatur, IL, USA.
authors.forename: Aram
authors.initials: A
authors.lastname: Barbaryan
authors.affiliation: Department of Internal Medicine, Hospital Sisters Health System - St. Mary's Hospital, Decatur, IL, USA.
authors.forename: Stefania L
authors.initials: SL
authors.lastname: Bailuc
authors.affiliation: Department of Internal Medicine, Hospital Sisters Health System - St. Mary's Hospital, Decatur, IL, USA.
authors.forename: Krishan
authors.initials: K
authors.lastname: Patel
authors.affiliation: Department of Internal Medicine, Hospital Sisters Health System - St. Mary's Hospital, Decatur, IL, USA.
authors.forename: Muhammad Wajih
authors.initials: MW
authors.lastname: Raqeem
authors.affiliation: Hospital Medicine, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Thakur
authors.affiliation: Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.
authors.forename: Aibek E
authors.initials: AE
authors.lastname: Mirrakhimov
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D002637:Chest Pain / Q000209:etiology; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology