A 62-year-old woman presents with acute chest pain after the death of her husband. Troponin I is mildly elevated, coronary angiography shows no obstructive stenosis, and left ventriculography reveals apical ballooning with basal hyperkinesis. Ejection fraction is 38%. Which region of the heart shows the characteristic wall motion abnormality?
- A Basal inferolateral segment
- B Right ventricular free wall
- C Left ventricular apex ✓
- D Interventricular septum only
Correct answer: C. Left ventricular apex
Explanation
Takotsubo (stress) cardiomyopathy classically produces apical akinesia or ballooning with compensatory basal hypercontractility, giving the appearance of a Japanese octopus trap. It affects postmenopausal women after emotional or physical stress, with mild troponin rise out of proportion to extensive wall motion abnormality. The basal inferolateral pattern is seen in the rare inverted variant, not the classic form, which kills that distractor.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.