Question:
A patient shows a pattern of myocardial stunning that does not match the territory of a single coronary artery on the ECG. What is the most likely diagnosis?
A patient shows a pattern of myocardial stunning that does not match the territory of a single coronary artery on the ECG. What is the most likely diagnosis?
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Reversible apical stunning that crosses coronary territories suggests a stress-induced cause.
Updated On: Jun 24, 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 reversible contractile dysfunction of a myocardial segment that persists for a time even after blood flow is restored. Usually it follows the distribution of a major coronary artery.
Step 2: Takotsubo (stress) cardiomyopathy is a temporary, sudden weakening or stunning of the heart muscle, typically producing apical ballooning that crosses several coronary territories and therefore does not correspond to a single vessel.
Step 3: Restrictive cardiomyopathy causes diastolic stiffness rather than reversible regional stunning, Brugada is a channelopathy with a characteristic ECG pattern not stunning, and isolated pericardial disease does not cause segmental wall stunning. Hence Takotsubo cardiomyopathy fits best.
Step 2: Takotsubo (stress) cardiomyopathy is a temporary, sudden weakening or stunning of the heart muscle, typically producing apical ballooning that crosses several coronary territories and therefore does not correspond to a single vessel.
Step 3: Restrictive cardiomyopathy causes diastolic stiffness rather than reversible regional stunning, Brugada is a channelopathy with a characteristic ECG pattern not stunning, and isolated pericardial disease does not cause segmental wall stunning. Hence Takotsubo cardiomyopathy fits best.
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