about 50 y old patient with severe posttraumatic stress disorder caused by death of near relative. The patient was admitted to out ER/ ICU with distinct and typical clinical affliction of acute coronary syndrome. Troponine I 0,8 (normal till 0,023), CK 210 U/l. In ECG we could see repolarisation disturbance without signs of ST-elevations. In TTE you can see myocardial movent disorder of apical LV-wall like an apical ballooning. No disturbance of RV. No US-B-lines, no pleural effusion, no sign of LVOTO despite the echocardiographic picture of hyperdynamic basal LV-wall-segments. In cardiac catheter no sign of coronary disease; we could see in cardiac catheter the typical movement disorder of Tako-Tsubo-CM as we could see in TTE before.
One question to the community: Is there ALWAYS a need for cardiac catheter if we see the typical echocardiographic picture of apical ballooning/ Tako-Tsubo-CM?