Systemic pathology: stress cardiomyopathy: practice question

A Pathology 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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Pathology · Systemic pathology: stress cardiomyopathy

Sample item

A 66-year-old woman develops chest pain and ST-segment elevation after the sudden death of her husband. Coronary angiography is normal, and echocardiography shows apical ballooning with basal hypercontractility. Which mechanism is proposed?

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

The answer and the reasoning

C. Catecholamine surge causing transient myocardial stunning

Takotsubo (stress) cardiomyopathy follows intense emotional or physical stress, with a catecholamine surge causing reversible apical stunning. Coronary arteries are normal, and histology may show contraction band necrosis. Left ventricular function usually recovers in weeks.

Option by option

  • A. Coxsackievirus myocarditis

    Coxsackievirus myocarditis causes diffuse inflammation and not a classic apical ballooning pattern.

  • B. Spontaneous coronary artery dissection

    Spontaneous coronary dissection would be seen on angiography as a flap or intramural haematoma.

  • C. Catecholamine surge causing transient myocardial stunning (correct)

    Correct. Excess catecholamines cause reversible myocardial stunning with normal coronary arteries.

  • D. Plaque rupture with thrombus in the left anterior descending artery

    Plaque rupture with thrombus would be visible on angiography as an occluded or stenosed artery.

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 Pathology question

What is the answer to this Pathology question?

The best answer is C, Catecholamine surge causing transient myocardial stunning. Takotsubo (stress) cardiomyopathy follows intense emotional or physical stress, with a catecholamine surge causing reversible apical stunning.

Why is "Coxsackievirus myocarditis" not the answer?

Coxsackievirus myocarditis causes diffuse inflammation and not a classic apical ballooning pattern.

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

Spontaneous coronary dissection would be seen on angiography as a flap or intramural haematoma.

Why is "Plaque rupture with thrombus in the left anterior descending artery" not the answer?

Plaque rupture with thrombus would be visible on angiography as an occluded or stenosed artery.

What concept does this question test?

It tests Systemic pathology: stress cardiomyopathy in Pathology. Coronary arteries are normal, and histology may show contraction band necrosis. Left ventricular function usually recovers in weeks.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Systemic pathology: stress cardiomyopathy?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.