Mayo Clinic criteria for Takotsubo cardiomyopathy

Q: Diagnosis of Takotsubo cardiomyopathy (broken-heart syndrome) includes all of the following except?

A) Absence of obstructive coronary disease or angiographic evidence of acute plaque rupture
B) Regional wall motion abnormalities typically in a single coronary distribution
C) Presence of EKG abnormalities
D) Troponin elevation
E) Absence of pheochromocytoma or myocarditis.


Answer:  B

Mayo Clinic diagnostic criteria 1 requires all of the following four criteria for the diagnosis

1. Transient left ventricular systolic (LV) dysfunction, which is typically regional and extend beyond a single epicardial coronary distribution*
2. Absence of obstructive coronary disease or angiographic evidence of acute plaque rupture^
3.  New EKG abnormalities (e.g ST elevation or T wave inversion) or some elevation in cardiac troponin. 
4. Absence of pheochromocytoma or myocarditis.

*rare exceptions within one coronary distribution and the global type have been reported.
^ If coronary disease is found, the diagnosis of stress cardiomyopathy can still be made if the wall motion abnormalities are not in the distribution of the coronary disease 2



References:

1. Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J 2008; 155:408. 

2. Templin C, Ghadri JR, Diekmann J, et al. Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy. N Engl J Med 2015; 373:929.