Recurrent long QT syndrome and syncope in transient apical ballooning syndrome (takotsubo cardiomyopathy)

Transient apical ballooning syndrome, or takotsubo cardiomyopathy is a syndrome characterized by reversible dilation of the left ventricular apex. It usually occurs in response to stress, and resolves completely in a few weeks. The present report describes a 55-year-old woman who presented with chest pain and syncope in response to emotional stress. Her electrocardiogram suggested acute coronary syndrome with prolonged QT. However, cardiac catheterization showed normal coronary arteries, with apical akinesis of the left ventricle. The patient's symptoms recurred 18 months later; subsequently, she was diagnosed with recurrent takotsubo cardiomyopathy with prolonged QT and syncope. The treatment, etiology and pathophysiology of takotsubo cardiomyopathy are discussed.