ABSTRACT Introduction: Tako-Tsubo cardiomyopathy describes a form of acute and reversible left ventricular dysfunction with a clinical presentation, ECG and cardiac biomarkers that makes it indistinguishable from acute coronary syndrome. Case Presentation: The authors present two cases of tako-tsubo cardiomyopathy in postmenopausal women, the first case following an emotional stressful event and a second case following a blood transfusion and probably associated with intravenous catecholamine perfusion. Both had unobstructed coronary arteries and regional wall-motion abnormalities typical of this syndrome. Conclusions: Tako-tsubo cardiomyopathy is a condition often misdiagnosed. A clinical presentation suggestive of acute coronary syndrome in a postmenopausal woman without history of coronary disease and in whom a precipitating stressful event can be found should lead the physician to suspect the diagnosis of tako-tsubo cardiomyopathy. This syndrome associated with blood transfusion has rarely been described.
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P. Margarida Serra Carvalho, J. Helena Lima, J. Bernardo Cunha, P. Glória Dinis Dias, J. Gonçalo Diniz Vieira and J. Manuel Nascimento Costa, "Tako-Tsubo Cardiomyopathy—The Role of Physical and Emotional Stressors: Two Case Report," International Journal of Clinical Medicine, Vol. 3 No. 2, 2012, pp. 145-150. doi: 10.4236/ijcm.2012.32029.
 Y. J. Akashi, et al., “Takotsubo Cardiomyopathy: A New Form of Acute, Reversible Heart Failure,” Circulation, Vol. 118, No. 25, 2008, pp. 2754-2762.
M. Zeb, et al., “Takotsubo Cardiomyopathy: A Diagnostic Challenge,” Postgraduate Medical Journal, Vol. 87, No. 1023, 2010, pp. 51-59.
A. Prasad, “Apical Ballooning Syndrome: An Important Differential Diagnosis of Acute Myocardial Infarction,” Circulation, Vol. 115, No. 5, 2007, pp. e56-e59.
M. Gianni, et al., “Apical Ballooning Syndrome or Takotsubo Cardiomyopathy: A Systematic Review,” European Heart Journal, Vol. 27, No. 13, 2006, pp. 1523-1529. doi:10.1093/eurheartj/ehl032
W. V. Vieweg, et al., “Depression, Stress, and Heart Disease in Earthquakes and Takotsubo Cardiomyopathy,” American Journal of Medicine, Vol. 124, No. 10, 2011, pp. 900-907. doi:10.1016/j.amjmed.2011.04.009
K. A. Bybee, et al., “Systematic Review: Transient Left Ventricular Apical Ballooning: A Syndrome That Mimics ST-Segment Elevation Myocardial Infarction,” Annals of Internal Medicine, Vol. 141, No. 11, 2004, pp. 858-865.
I. S. Wittstein, et al., “Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress,” New England Journal of Medicine, Vol. 352, No. 6, 2005, pp. 539-548. doi:10.1056/NEJMoa043046
S. B. Nguyen, et al., “Do Comorbid Psychiatric Disorders Contribute to the Pathogenesis of Tako-Tsubo Syndrome? A Review of Pathogenesis,” Congestive Heart Failure, Vol. 15, No. 1, 2009, pp. 31-34.
O. Wever-Pinzon and L. Tami, “Takotsubo Cardiomyopathy Following a Blood Transfusion,” Congestive Heart Failure, Vol. 16, No. 3, 2010, pp. 129-131.
Y. Abe, A. Tamura and J. Kadota, “Prolonged Cardiogenic Shock Caused by a High-Dose Intravenous Administration of Dopamine in a Patient with Takotsubo Cardiomyopathy,” International Journal of Cardiology, Vol. 141, No. 1, 2001, pp. e1-e3.