PT - JOURNAL ARTICLE AU - Rahman Shah AU - Michela R Shelton AU - Kodangudi B Ramanathan TI - Lesson of the month 1: Broken heart in the intensive care unit AID - 10.7861/clinmedicine.14-4-447 DP - 2014 Aug 01 TA - Clinical Medicine PG - 447--448 VI - 14 IP - 4 4099 - http://www.rcpjournals.org/content/14/4/447.short 4100 - http://www.rcpjournals.org/content/14/4/447.full SO - Clin Med2014 Aug 01; 14 AB - Takotsubo cardiomyopathy (TCM) is an unusual form of acute cardiomyopathy showing left ventricular apical ballooning. TCM can masquerade as ST elevation myocardial infarction (STEMI). TCM usually occurs following a variety of emotional stressors, but physical stressors can also trigger the condition, as highlighted by the present case. TCM can occur after an acute medical illness; therefore, physicians should be aware of this condition as a potential cause of inotrope-resistant hypotension. In patients with hypotension and moderate-to-severe left ventricular outflow tract (LVOT) obstruction, inotropic agents should be avoided, because they can worsen the degree of obstruction. Instead, beta-blockers are preferred, because they are capable of resolving the obstruction and consequently improve the haemodynamics.