Question:hard
A patient shows a myocardial stunning pattern that does not match the territory of the ECG changes. What is the diagnosis?
A patient shows a myocardial stunning pattern that does not match the territory of the ECG changes. What is the diagnosis?
Show Hint
Reversible apical ballooning that does not respect a coronary territory.
Updated On: Jun 23, 2026
- Takotsubo cardiomyopathy
- Restrictive cardiomyopathy
- Brugada cardiomyopathy
- Pericardial disease
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: The clue is the discordance - the area of stunned, hypocontractile myocardium does not line up with the coronary territory the ECG would predict. A true coronary occlusion produces matched changes, so a mismatch suggests a non-coronary cause of stunning.
Step 2: Stress (Takotsubo) cardiomyopathy fits perfectly. It produces transient apical ballooning and reversible wall-motion abnormalities extending beyond any one vessel's supply, often after emotional or physical stress, recovering over days to weeks.
Step 3: The alternatives fail the description. Restrictive cardiomyopathy gives diastolic dysfunction, Brugada is defined by its ECG pattern not regional stunning, and pericardial disease involves the surrounding sac. The territory-ECG mismatch nails the diagnosis.\[\boxed{\text{Takotsubo cardiomyopathy}}\]
Step 2: Stress (Takotsubo) cardiomyopathy fits perfectly. It produces transient apical ballooning and reversible wall-motion abnormalities extending beyond any one vessel's supply, often after emotional or physical stress, recovering over days to weeks.
Step 3: The alternatives fail the description. Restrictive cardiomyopathy gives diastolic dysfunction, Brugada is defined by its ECG pattern not regional stunning, and pericardial disease involves the surrounding sac. The territory-ECG mismatch nails the diagnosis.\[\boxed{\text{Takotsubo cardiomyopathy}}\]
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