À propos d'un cas de syndrome de Tako-Tsubo ou comment une situation stressante peut vous amener en salle de coronarographie…

Management and Emergency Department (ED) evaluation of patients with chest pain remains challenging. We report a rare cause of chest pain: Tako-Tsubo syndrome. This cardiomyopathy mimics symptoms of acute myocardial infarction with acute chest pain associated to electrocardiographic changes and moderate cardiac biomarkers release. However, coronary angiography reveals normal coronary arteries and echocardiography or left ventriculography show transient dysfunction usually in the apical segments, together with hyperkinesis in the basal segments. This cardiomyopathy occurs in elderly women exposed to emotional or physical stress. Prognosis is good, provided that the patients survive the severe heart failure state, with correction of the left ventricular dysfunction within a few days. The differential diagnosis with an acute coronary syndrome is not yet possible in the ED and these patients can be exposed to inappropriate therapy such as thrombolysis.