2. Overview
• Left ventricular apical akinesis
• Octopus trap
• Mimics acute coronary syndrome
• ST elevation
• Elevated troponin
• No Coronary Stenosis
• Unknown Etiology
• Triggered by emotional stressor
3. Overview
• 1.7-2.2% of patients who had suspected ACS
• Women 90%
• Asian or Caucasian.
• 57.2% were Asian,
• 40% were Caucasian
• 2.8% were other races.
• Postmenopausal 90%.
5. Presentation
• Most common ACS
• chest pain
• Dyspnea
• Less common
• Palpitations,
• Nausea/vomiting
• Syncope
• Rare
• Cardiogenic shock
6. Reported triggers
• Emotional
• Death of a loved one (including pets)
• Surprise party
• Family member being arrested
• Fierce argument
• Robbery
• Public speaking
• Surgery – Hysterectomy, Cholecystectomy
• Stress echo with dobutamine
• Opiate withdrawal
• Thyrotoxicosis
• Physical exhaustion ( triathlon, sexual, gym)- males