Stress, myocardial infarction, and the "tako-tsubo" phenomenon

Emotional distress as a trigger for acute myocardial infarction is beginning to gain credibility as it is recognised that traditional risk factors can account for only half of all myocardial infarctions. Here, three cases of myocardial infarction are presented in the setting of an acute emotional stressor, with coronary angiography showing only minimal coronary artery disease. In all cases striking wall motion abnormalities, mimicking a "tako-tsubo'', were noted with complete resolution within 30 days. This pattern suggests tako-tsubo-like transient left ventricular dysfunction.