Question:
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?
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Reversible apical ballooning that does not respect a coronary territory.
Updated On: Jun 23, 2026
- Takotsubo cardiomyopathy
- Restrictive cardiomyopathy
- Brugada cardiomyopathy
- Pericardial disease
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The Correct Option is A
Solution and Explanation
Step 1: Myocardial stunning is a reversible contractile dysfunction of a myocardial segment that persists for a variable period (around two weeks) even after ischaemia has been relieved, for example by angioplasty or bypass surgery.
Step 2: Takotsubo (stress) cardiomyopathy is a temporary, sudden weakening or 'stunning' of the heart muscle, classically the left ventricular apex, that balloons out. A key feature is that the regional wall-motion abnormality does NOT correspond to a single coronary artery territory or match the ECG changes, distinguishing it from a true infarct.
Step 3: Restrictive cardiomyopathy causes stiff, poorly filling ventricles; Brugada is a channelopathy with a characteristic ECG; pericardial disease affects the sac, not the myocardial wall motion in this way. The mismatch between stunning pattern and ECG points to option (a), Takotsubo cardiomyopathy.
Step 2: Takotsubo (stress) cardiomyopathy is a temporary, sudden weakening or 'stunning' of the heart muscle, classically the left ventricular apex, that balloons out. A key feature is that the regional wall-motion abnormality does NOT correspond to a single coronary artery territory or match the ECG changes, distinguishing it from a true infarct.
Step 3: Restrictive cardiomyopathy causes stiff, poorly filling ventricles; Brugada is a channelopathy with a characteristic ECG; pericardial disease affects the sac, not the myocardial wall motion in this way. The mismatch between stunning pattern and ECG points to option (a), Takotsubo cardiomyopathy.
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