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Stress, emotion and the heart: tako-tsubo cardiomyopathy
  1. M Bilal Iqbal1,
  2. James C Moon1,
  3. Oliver P Guttmann1,
  4. Paul Shanahan2,
  5. Peter J Goadsby3,
  6. Diana R Holdright4
  1. 1Department of Cardiology, The Heart Hospital, London, UK
  2. 2Department of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
  3. 3The National Hospital for Neurology and Neurosurgery, London, UK
  4. 4The Heart Hospital, London, UK
  1. Correspondence to:
 Dr Diana R Holdright
 The Heart Hospital, Westmoreland Street, London WIG 8PH, UK; Diana.Holdright{at}


Tako-tsubo cardiomyopathy is a cardiac syndrome precipitated by profound emotional stress and anxiety, particularly in middle-aged women. It presents as a mimic of acute myocardial infarction, but coronary angiography shows normal coronary arteries and a characteristic left ventriculogram resembling an “octopus pot”. The condition seems to have a favourable prognosis. Initially described in Japan, and with many names in the literature, it is being increasingly recognised in the West owing to early coronary angiography and primary coronary intervention, accounting for up to 1 in 30 primary cases of angioplasty in some institutions. A typical case is described, and the clinical features, pathophysiology and management reviewed.

  • ACE, angiotensin-converting enzyme
  • AMI, acute myocardial infarction
  • ECG, electrocardiogram
  • SUNCT, short-lasting unilateral neuralgiform headache attacks with conjuctival injection and tearing

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  • Competing interests: None.

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