Cardiology: Takotsubo cardiomyopathy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: Takotsubo cardiomyopathy

Sample item

A 64-year-old woman develops central chest pain two days after her husband dies. ECG shows anterior ST elevation and troponin is mildly raised. Coronary angiography shows no obstructive lesion, and left ventriculography reveals apical ballooning with basal hyperkinesis. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Takotsubo (stress) cardiomyopathy

Takotsubo cardiomyopathy typically affects postmenopausal women after an emotional or physical stress, mimicking anterior STEMI with disproportionately modest troponin rise and normal coronaries. The left ventricle shows transient apical ballooning that usually recovers over weeks. Management is supportive, with beta-blockers or ACE inhibitors used and complications such as heart failure treated.

Option by option

  • A. Spontaneous coronary artery dissection

    Dissection of a coronary artery would be visible as a flap or intramural haematoma on angiography.

  • B. Prinzmetal variant angina

    Variant angina causes transient ST elevation from focal spasm, not a wide region of apical akinesis with basal hyperkinesis.

  • C. Acute viral myocarditis

    Myocarditis follows a viral prodrome and does not produce a characteristic apical ballooning pattern with normal coronaries after stress.

  • D. Takotsubo (stress) cardiomyopathy (correct)

    Transient apical ballooning with normal coronaries after emotional stress defines Takotsubo cardiomyopathy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Takotsubo (stress) cardiomyopathy. Takotsubo cardiomyopathy typically affects postmenopausal women after an emotional or physical stress, mimicking anterior STEMI with disproportionately modest troponin rise and normal coronaries.

Why is "Spontaneous coronary artery dissection" not the answer?

Dissection of a coronary artery would be visible as a flap or intramural haematoma on angiography.

Why is "Prinzmetal variant angina" not the answer?

Variant angina causes transient ST elevation from focal spasm, not a wide region of apical akinesis with basal hyperkinesis.

Why is "Acute viral myocarditis" not the answer?

Myocarditis follows a viral prodrome and does not produce a characteristic apical ballooning pattern with normal coronaries after stress.

What concept does this question test?

It tests Cardiology: Takotsubo cardiomyopathy in General Medicine. The left ventricle shows transient apical ballooning that usually recovers over weeks. Management is supportive, with beta-blockers or ACE inhibitors used and complications such as heart failure treated.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: Takotsubo cardiomyopathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.